Individual
DR. ANDREW JOHN KOLLATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7270 FORESTVIEW LN N STE 250, MAPLE GROVE, MN 55369
(763) 424-9202
Mailing address
7270 FORESTVIEW LN N STE 250, MAPLE GROVE, MN 55369-5605
(763) 424-9202
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
1001549
WI
1223G0001X
General Practice Dentistry
Primary
D14111
MN
Other
Enumeration date
07/28/2017
Last updated
07/22/2019
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