| NPI | 1669530101 |
|---|---|
| Doing Business As | PARK DENTAL MINNETONKA |
| Entity Type | Organization |
| Authorized Contact | SHANNON HESSE Credentialing Specialist 651-746-2815 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2020-01-31 |