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Organization

SALO DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CARRIE WISE (CFO)
(763) 557-6893
Entity
Organization

Contact information

Practice address
3900 VINEWOOD LN N STE 13, MINNEAPOLIS, MN 55441-1155
(763) 557-6893
Mailing address
3900 VINEWOOD LN N STE 13, MINNEAPOLIS, MN 55441-1155
(763) 557-6893

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D10976
DENTAL LICENSE
MN
Enumeration date
10/03/2022
Last updated
10/03/2022
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