| NPI | 1265097653 |
|---|---|
| Doing Business As | THE DENTAL SPECIALIST ST CROIX VALLEY |
| Entity Type | Organization |
| Authorized Contact | SHANNON HESSE Credentialing Specialist 651-746-2815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2020-10-28 |