Organization
NORTHSTAR ORTHODONTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CYNTHIA J. KELLY (CEO/CFO)
(218) 732-9503
Entity
Organization
Contact information
Practice address
218 INDUSTRIAL PARK RD, PARK RAPIDS, MN 56470-3508
(218) 732-9503
Mailing address
218 INDUSTRIAL PARK RD, PARK RAPIDS, MN 56470-3508
(218) 732-9503
Taxonomy
Speciality
Code
Description
License number
State
292200000X
Dental Laboratory
Primary
DL109
MN
Other
Enumeration date
05/10/2016
Last updated
05/10/2016
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