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1306130430
GROVELAND DENTAL P.A.
SAINT PAUL, MN
NPI
1306130430
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Entity Type
Organization
Authorized Contact
MATTHEW COLAIZY
President
651-298-0024
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center, Dental
(Licence: MN 11657)
Enumeration Date
2011-06-07
Last Update Date
2011-06-07
Business Address
GROVELAND DENTAL P.A.
2042 SAINT CLAIR AVE
SAINT PAUL, MN 55105-1650
Phone number: 651-298-0024
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Mailing Address
GROVELAND DENTAL P.A.
2042 SAINT CLAIR AVE
SAINT PAUL, MN 55105-1650
Phone number: 651-298-0024
Copy
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