Organization
CHILDREN'S DENTAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SARAH WOVCHA (EXECUTIVE DIRECTOR)
(612) 746-1530
Entity
Organization
Contact information
Practice address
229 W LAKE ST, CHISHOLM, MN 55719
(612) 746-1530
Mailing address
636 BROADWAY ST NE, MINNEAPOLIS, MN 55413-2164
(612) 746-1530
(612) 746-1531
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
—
Other
Enumeration date
10/02/2015
Last updated
08/20/2018
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