Individual
DR. CORINE NICOLE MCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
12904 CENTRAL AVE NE, BLAINE, MN 55434-4147
(763) 755-1330
(763) 755-4305
Mailing address
11716 ARNOLD PALMER TRL, BLAINE, MN 55449-4520
(763) 717-0007
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11538
MN
Other
Enumeration date
12/07/2006
Last updated
07/08/2007
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