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Organization

WEST SIDE COMMUNITY HEALTH SERVICES, INC.

Active
Parent organization
WEST SIDE COMMUNITY HEALTH SERVICES, INC.
Other names
East Side Family Dental Clinic
Organization subpart
Yes

Provider details

NPI number
Legal business name
WEST SIDE COMMUNITY HEALTH SERVICES, INC.
Authorized official
REUBEN MOORE (CEO)
(651) 602-7500
Entity
Organization

Contact information

Practice address
895 E. 7TH ST, ST PAUL, MN 55106-3852
(651) 772-9757
(651) 772-9959
Mailing address
153 CESAR CHAVEZ ST, SAINT PAUL, MN 55107-2226
(651) 602-7500
(651) 602-7513

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
302133
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
955353300
MN
Enumeration date
01/16/2007
Last updated
05/15/2024
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