| NPI | 1669184016 |
|---|---|
| Doing Business As | ACACIA DENTAL |
| Entity Type | Organization |
| Authorized Contact | CHAD HENDRICKS Credentialing 612-859-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-12-16 |
| Last Update Date | 2022-12-16 |