Organization
NORTHPARK DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL WAYNE CHADBOURN DDS (PRESIDENT)
(763) 786-1560
Entity
Organization
Contact information
Practice address
9120 BALTIMORE ST NE, BLAINE, MN 55449-4337
(763) 786-1560
(763) 786-4390
Mailing address
9120 BALTIMORE ST NE, BLAINE, MN 55449-4337
(763) 786-1560
(763) 786-4390
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/28/2007
Last updated
12/28/2007
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