| NPI | 1659091007 |
|---|---|
| Doing Business As | MT VERNON CENTER FOR DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CHAD HENDRICKS Credentialing 612-859-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2022-08-29 |