Organization
ABC DENTAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHERINE M C BOLTERMAN D.D.S. (OWNER PRESIDENT)
(763) 421-4640
Entity
Organization
Contact information
Practice address
3371 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2624
(763) 421-4640
(763) 421-0112
Mailing address
3371 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2624
(763) 421-4640
(763) 421-0112
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D11438
MN
Other
Enumeration date
01/04/2007
Last updated
08/22/2020
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