NPI 1306009667

Alternative Dental Network

Organisation Preferred Provider Organization Golden Valley, MN

Practice location

Address: 8014 Hwy 55 STE 154, Golden Valley, MN 55427
Phone: (612) 280-0350
Mailing address: 8014 Highway 55 # 154, Golden Valley, MN 55427-4712

Authorised official

Name: Lavern Thomas
Title: Administrator
Phone: (612) 280-0350

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X

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Registry record

NPI: 1306009667
Entity type: Organization
NPI issued: 8 Jul 2008
Record last updated: 8 Jul 2008

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.