Organization · Type 2 NPI
Minneapolis-St. Paul Periodontics
Periodontics · Fridley, MN
NPI number
1013216811
Active
Practice location
1109 East Moore Lake Drive
Fridley, MN 55432
Fax (651) 439-2211
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Periodontics Primary | 1223P0300X | D11710 (MN) |
Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
Another provider at this address
Other periodontics providers in Fridley
About NPI 1013216811
Minneapolis-St. Paul Periodontics's National Provider Identifier is 1013216811, issued on Mar 18, 2011. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Fridley, MN. The record was last updated on Mar 18, 2011.