Organization
BRADLEY S. ISAACSON, DDS, PA
Active
Other names
Tangletown Dental
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD S ISAACSON DDS (OWNER)
(612) 822-2324
Entity
Organization
Contact information
Practice address
4831 NICOLLET AVE, MINNEAPOLIS, MN 55419-5534
(612) 822-2324
(612) 822-6763
Mailing address
4831 NICOLLET AVE, MINNEAPOLIS, MN 55419-5534
(612) 822-2324
(612) 822-6763
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08320
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08320
DELTA DENTAL
MN
01
—
1427062819
INDIVIDUAL NPI
—
05
—
3018382
—
MN
Enumeration date
07/03/2007
Last updated
01/14/2015
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