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Organization

CROW RIVER DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GREGORY STEPHEN GLAVAN D.D.S. (DENTIST/OWNER)
(763) 276-1410
Entity
Organization

Contact information

Practice address
405 BABCOCK BLVD. E, SUITE 130, DELANO, MN 55328
(763) 276-1410
(763) 276-1411
Mailing address
405 BABCOCK BLVD. E, SUITE 130, DELANO, MN 55328-0405
(763) 276-1410
(763) 276-1411

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10572
MN

Other

Enumeration date
01/06/2012
Last updated
01/06/2012
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