Organization
ALLINA HEALTH SYSTEM
Active
Other names
Allina Health Centennial Lakes Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINICA TALLARICO (COO)
(612) 222-2222
Entity
Organization
Contact information
Practice address
7373 FRANCE AVE S STE 202, EDINA, MN 55435-4551
(952) 835-1311
Mailing address
PO BOX 43, MAIL ROUTE 10585, MINNEAPOLIS, MN 55440-0043
(612) 262-1166
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
02/04/2013
Last updated
02/25/2025
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