Organization
PLYMOUTH DENTAL CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. P. LOUIS MICHELICH D.D.S. (PRESIDENT)
(763) 551-0501
Entity
Organization
Contact information
Practice address
4000 ANNAPOLIS LN N, SUITE 103, PLYMOUTH, MN 55447-5480
(763) 551-0501
(612) 573-6687
Mailing address
4000 ANNAPOLIS LN N, SUITE 103, PLYMOUTH, MN 55447-5480
(763) 551-0501
(612) 573-6687
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7115
MN
Other
Enumeration date
06/15/2007
Last updated
08/22/2020
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