Organization
MINNESOTA DURABLE MEDICAL EQUIPMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK BALDWIN (DENTIST)
(612) 210-2452
Entity
Organization
Contact information
Practice address
15600 36TH AVE N STE 270, MINNEAPOLIS, MN 55446-3372
(612) 210-2452
Mailing address
15600 36TH AVE N STE 270, MINNEAPOLIS, MN 55446-3372
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
07/03/2018
Last updated
07/03/2018
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