Organization
NORTHERN ORTHODONTICS
Active
Parent organization
ST. CROIX VALLEY DENTAL, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. CROIX VALLEY DENTAL, PLLC
Authorized official
DR. DOUG S WOLFF D.D.S. (OWNER)
(651) 439-2600
Entity
Organization
Contact information
Practice address
1109 EAST MOORE LAKE DRIVE, FRIDLEY, MN 55432
(651) 439-2600
(651) 439-2211
Mailing address
1109 EAST MOORE LAKE DRIVE, FRIDLEY, MN 55432
(651) 439-2600
(651) 439-2211
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D111236
MN
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/21/2011
Last updated
03/21/2011
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