Organization · Type 2 NPI
Grand Avenue Dental, LLC
Dental Clinic/Center · St. Paul, MN
NPI number
1154933661
Active
Practice location
960 Grand Ave
St. Paul, MN 55105-3014
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
4 other providers at this address
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About NPI 1154933661
Grand Avenue Dental, LLC's National Provider Identifier is 1154933661, issued on Aug 18, 2020. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in St. Paul, MN. The record was last updated on Aug 18, 2020.