Pine Ridge Dental Pa

NPI 1033206750 - Dentist - 1223G0001X

NPI Details
NPI 1033206750
Enumeration Date 10/06/2006
Last Updated 08/21/2014
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name JENNIFER JENNIFER
Position DENTIST
Phone (763) 856-5100
Fax (763) 856-0366
Practice Location
26273 2ND ST E
SUITE A
ZIMMERMAN MN, 55398, US
Phone (763) 856-5100
Fax (763) 856-0366
Business Location
PO BOX 223
26273 2ND ST E SUITE A
ZIMMERMAN MN, 55398, US
Phone (763) 856-5100
Fax (763) 856-0366
Toxanomy
Taxonomy Code 1223G0001X
License State
License Number
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According to our database, Pine Ridge Dental Pa NPI is 1033206750, taxonomy code is 1223G0001X Pine Ridge Dental Pa physically located at 26273 2nd St E, Zimmerman MN, 55398. NPI Number 1033115704 has the healthcare provider type.

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1033206750 NPI number is provided on an as is basis without warranty of any kind. 1033206750 is maintained by the National Plan & Provider Enumeration System. The contents of Pine Ridge Dental Pa are for informational purposes only.