Organization · Type 2 NPI
Central Minnesota Pediatric Dentists PA
Pediatric Dentistry · Big Lake, MN
NPI number
1265873707
Active
Practice location
570 Humboldt Dr Ste 102
Big Lake, MN 55309-4844
Fax (320) 251-2661
Mailing address
1900 Centracare Cir Ste 350
St. Cloud, MN 56303-5000
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist | 122300000X | D7765 (MN) |
| Pediatric Dentistry Primary | 1223P0221X | D11073 (MN) |
| Pediatric Dentistry | 1223P0221X | D11344 (MN) |
| Pediatric Dentistry | 1223P0221X | D12885 (MN) |
Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
About NPI 1265873707
Central Minnesota Pediatric Dentists PA's National Provider Identifier is 1265873707, issued on Jul 12, 2013. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Big Lake, MN. The record was last updated on Jul 12, 2013.