| NPI | 1689741787 |
|---|---|
| Doing Business As | NICOLLET STATION DENTAL |
| Entity Type | Organization |
| Authorized Contact | LORI JACOBS Office Manager 612-338-5557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2022-07-21 |