Organization
GOLDEN VALLEY KIDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADENA FERN BORODKIN DDS, MS (PEDIATRIC DENTIST)
(763) 222-1299
Entity
Organization
Contact information
Practice address
7575 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55427-4562
(763) 222-1299
Mailing address
5128 TIFTON DR, EDINA, MN 55439-1457
(612) 419-3040
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D11961
MN
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
D11564
MN
Other
Enumeration date
11/22/2017
Last updated
11/22/2017
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