NPI 1063834588

Chaska Pediatric Dentistry, P.A.

Organisation Dental Clinic/Center Chaska, MN

Practice location

Address: 111 Hundertmark Rd Suite 304n, Chaska, MN 55318-4551
Phone: (952) 475-3135
Mailing address: 250 Central Ave N Suite 113, Wayzata, MN 55391-1206

Authorised official

Name: Taylor Stephens
Title: Owner/President
Phone: (952) 475-3135

Registered specialties

Dental Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QD0000X Licence D12818 (MN)

Other Clinic/Center providers in Minnesota →

Registry record

NPI: 1063834588
Entity type: Organization
NPI issued: 17 Jan 2014
Record last updated: 17 Jan 2014

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.