Organization
MARK I. MALTERUD, D.D.S., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK IVAN MALTERUD D.D.S.,M.A.G.D. (OWNER)
(651) 699-2822
Entity
Organization
Contact information
Practice address
770 MOUNT CURVE BLVD, SAINT PAUL, MN 55116-1165
(651) 699-2822
(651) 699-3009
Mailing address
770 MOUNT CURVE BLVD, SAINT PAUL, MN 55116-1165
(651) 699-2822
(651) 699-3009
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9454
MN
Other
Enumeration date
03/23/2007
Last updated
08/22/2020
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