NPI 1003245333

Dental Specialists of Minnesota, PLLC

Organisation Periodontics Fridley, MN

Practice location

Address: 1109 Moore Lake Dr E, Fridley, MN 55432-5171
Phone: (763) 571-9990
Fax: (763) 572-2226
Mailing address: 2200 County Road C W Suite 2210, Roseville, MN 55113-2550

Authorised official

Name: Alan Law
Title: President
Phone: (651) 633-0500

Registered specialties

Periodontics Primary

Dental Providers Taxonomy 1223P0300X

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Registry record

NPI: 1003245333
Entity type: Organization
NPI issued: 7 Nov 2013
Record last updated: 28 Oct 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.