Organization
ORCHARD DENTAL GROUP, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT J MAROLT D.D.S. (PARTNER)
(651) 770-2699
Entity
Organization
Contact information
Practice address
12 LONG LAKE RD # 12, MAHTOMEDI, MN 55115-6814
(651) 770-2699
(651) 770-9896
Mailing address
12 LONG LAKE RD # 12, MAHTOMEDI, MN 55115-6814
(651) 770-2699
(651) 770-9896
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D9611
MN
Other
Enumeration date
06/03/2009
Last updated
06/03/2009
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