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Organization

ST. CLOUD TECHNICAL COLLEGE COMMUNITY DENTAL CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELISSA LINDGREN (CLINIC COORDINATOR)
(320) 308-5310
Entity
Organization

Contact information

Practice address
1540 NORTHWAY DR, SAINT CLOUD, MN 56303-1240
(320) 308-5310
(320) 308-5055
Mailing address
1540 NORTHWAY DR, SAINT CLOUD, MN 56303-1240
(320) 308-5310
(320) 308-5055

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7913
MN

Other

Enumeration date
03/22/2007
Last updated
08/22/2020
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