Organization
SOUTHSIDE COMMUNITY HEALTH SERVICES, INC.
Active
Other names
Southside Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ANN CAZABAN (EXECUTIVE DIRECTOR)
(612) 821-2025
Entity
Organization
Contact information
Practice address
4243 4TH AVE S, MINNEAPOLIS, MN 55409-2113
(612) 822-9030
(612) 821-2818
Mailing address
4243 4TH AVE S, MINNEAPOLIS, MN 55409-2113
(612) 822-9030
(612) 821-2818
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
635323100
—
MN
Enumeration date
03/23/2007
Last updated
01/05/2026
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