Organization
PAUL BOETTNER D.D.S. PLLC
Active
Other names
Bay Creek Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL D BOETTNER DDS (OWNER)
(763) 476-6774
Entity
Organization
Contact information
Practice address
1495 COUNTY ROAD 101 N, SUITE 2, PLYMOUTH, MN 55447-3078
(763) 476-6774
Mailing address
1495 COUNTY ROAD 101 N, SUITE 2, PLYMOUTH, MN 55447
(763) 476-6774
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12160
MN
Other
Enumeration date
08/10/2007
Last updated
06/15/2012
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