Individual provider · Type 1 NPI
Gracie Isabella Comeau
Dental Therapist · Andover, MN
Practice location
2258 Bunker Lake Blvd NW
Andover, MN 55304-3900
Mailing address
4518 Cedar Lake Rd S Apt 6
Minneapolis, MN 55416-3750
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Hygienist | 124Q00000X | H11422 (MN) |
| Dental Therapist Primary | 125J00000X | DT164 (MN) |
Dental Therapist: A Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the relevant state board or a tribal entity to provide services within the scope of their practice under the supervision of a dentist. Functions that may be delegated to the dental therapist vary based on the needs of the dentist, the educational preparation of the dental therap…
Another provider at this address
About NPI 1114627205
Gracie Isabella Comeau's National Provider Identifier is 1114627205, issued on Mar 7, 2023. The primary taxonomy on file is Dental Therapist (125J00000X), and the practice location is in Andover, MN. The record was last updated on Jun 21, 2023.