Organization
NORTHLAND DENTAL PARTNERS, PLLC
Active
Parent organization
NORTHLAND DENTAL PARTNERS, PLLC
Other names
Central Avenue Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHLAND DENTAL PARTNERS, PLLC
Authorized official
CELIA HAYES (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization
Contact information
Practice address
12371 ULYSSES ST NE, BLAINE, MN 55434-3910
(763) 203-6100
Mailing address
12371 ULYSSES ST NE, BLAINE, MN 55434-3910
(763) 203-6100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/13/2022
Last updated
02/01/2024
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