NPI 1114627205

Gracie Isabella Comeau

Practitioner Dental Therapist Andover, MN

Practice location

Address: 2258 Bunker Lake Blvd NW, Andover, MN 55304-3900
Phone: (793) 390-8995
Mailing address: 4518 Cedar Lake Rd S APT 6, Minneapolis, MN 55416-3750

Registered specialties (2)

Dental Therapist Primary

Dental Providers Taxonomy 125J00000X Licence DT164 (MN)

Other Dental Therapist providers in Minnesota →

Dental Hygienist

Dental Providers Taxonomy 124Q00000X Licence H11422 (MN)

Other Dental Hygienist providers in Minnesota →

Registry record

NPI: 1114627205
Entity type: Individual
Sex (as registered): Female
NPI issued: 7 Mar 2023
Record last updated: 21 Jun 2023

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.