Organization
BURNSVILLE DENTAL, P.A.
Active
Other names
Northstar Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ISABELLA CONSTANTIN (BUSINESS MANAGER)
(952) 892-7700
Entity
Organization
Contact information
Practice address
675 E NICOLLET BLVD STE 120, BURNSVILLE, MN 55337-6748
(952) 892-7700
Mailing address
675 E NICOLLET BLVD STE 120, BURNSVILLE, MN 55337-6748
(952) 892-7700
(952) 892-7767
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
10615
MN
1223G0001X
General Practice Dentistry
Primary
D11856
MN
1223G0001X
General Practice Dentistry
D12917
MN
Other
Enumeration date
10/07/2011
Last updated
10/07/2011
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