Birch Lake Dental Pa

NPI 1083853113 - Dentist - 1223G0001X

NPI Details
NPI 1083853113
Enumeration Date 02/12/2009
Last Updated 02/12/2009
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name GEETHA J GEETHA
Position OWNER
Phone (651) 429-0404
Fax (651) 429-0472
Practice Location
2641 WHITE BEAR PARKWAY
WHITE BEAR LAKE MN, 55110, US
Phone (651) 429-0404
Fax (651) 429-0472
Business Location
2641 WHITE BEAR PARKWAY
WHITE BEAR LAKE MN, 55110, US
Phone (651) 429-0404
Fax (651) 429-0472
Toxanomy
Taxonomy Code 1223G0001X
License State Minnesota
License Number 7712MN
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According to our database, Birch Lake Dental Pa NPI is 1083853113, taxonomy code is 1223G0001X and license number is 7712MN, license state is located at Minnesota. Birch Lake Dental Pa physically located at 2641 White Bear Parkway, White Bear Lake MN, 55110. NPI Number 1033115704 has the healthcare provider type.

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1083853113 NPI number is provided on an as is basis without warranty of any kind. 1083853113 is maintained by the National Plan & Provider Enumeration System. The contents of Birch Lake Dental Pa are for informational purposes only.