Organization · Type 2 NPI

Family Orthodontic Specialists PLC

Orthodontics and Dentofacial Orthopedics Dentistry · St. Louis Park, MN

NPI number 1104569839 Active

Practice location

4959 Excelsior Blvd Ste 200
St. Louis Park, MN 55416-3003

Fax (952) 920-8979

Specialties and licenses

Taxonomy	Code	License
Orthodontics and Dentofacial Orthopedics Dentistry Primary	1223X0400X	None listed

Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…

4 other providers at this address

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NPI record

NPI: 1104569839
Entity type: Organization (Type 2)
Issued: Apr 20, 2022
Last updated: Apr 20, 2022
Status: Active
Subpart: Yes of Family Orthodontic Specialists PLC

Other names

Woodlake Orthodontics ST Louis Park · doing business as

Authorized official

Celia Hayes
Credentialing Coordinator
(217) 540-2100

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About NPI 1104569839

Family Orthodontic Specialists PLC's National Provider Identifier is 1104569839, issued on Apr 20, 2022. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in St. Louis Park, MN. The record was last updated on Apr 20, 2022.