Organization
METROPOLITAN STATE UNIVERSITY
Active
Other names
Mertopolitan State University Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAYNE CERNOHOUS DDS (DENTAL FACULTY COORDINATOR)
(651) 621-8840
Entity
Organization
Contact information
Practice address
1670 BEAM AVE, #203, MAPLEWOOD, MN 55109-1201
(651) 621-8840
(651) 621-8841
Mailing address
1670 BEAM AVE, #203, MAPLEWOOD, MN 55109-1201
(651) 621-8840
(651) 621-8841
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/30/2014
Last updated
04/30/2014
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