Organization
BLUE RIDGE DENTAL CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN J MCHUGH DDS (VICE PRESIDENT)
(952) 938-8858
Entity
Organization
Contact information
Practice address
11601 MINNETONKA MILLS RD, SUITE D, MINNETONKA, MN 55305-5161
(952) 938-8858
Mailing address
11601 MINNETONKA MILLS RD, SUITE D, MINNETONKA, MN 55305-5161
(952) 938-8858
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11518
MN
Other
Enumeration date
01/02/2007
Last updated
08/22/2020
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