Organization
UNIVERSITY OF MINNESOTA PEDIATRIC DENTAL CLINIC
Active
Parent organization
UMPHYSICIANS
Organization subpart
Yes
Provider details
NPI number
Legal business name
UMPHYSICIANS
Authorized official
MARY A JOHNSON (COO)
(612) 884-0802
Entity
Organization
Contact information
Practice address
701 25TH AVE S, SUITE 400, MINNEAPOLIS, MN 55454-1513
(651) 659-4900
(651) 659-4901
Mailing address
701 25TH AVE S, SUITE 400, MINNEAPOLIS, MN 55454-1513
(651) 659-4900
(651) 659-4901
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
01/04/2012
Last updated
06/05/2013
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