Organization
IDEAL DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRENT MITCHEL ANDERSON DDS (PARTNER/OWNER)
(651) 353-6651
Entity
Organization
Contact information
Practice address
2130 CLIFF RD STE 107, EAGAN, MN 55122-2486
(651) 452-3112
Mailing address
7810 SAINT CROIX TRAIL LN S, HASTINGS, MN 55033-9737
(651) 353-6651
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689663148
—
MN
Enumeration date
08/07/2019
Last updated
08/07/2019
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