Maple Grove Family Dental Clinic, Pa
LBN: Maple Grove Family Dental Clinic, Pa
Maple Grove Family Dental Clinic, Pa is an health care organization with primary practice located at 12000 Elm Creek Blvd N Suite #220, Maple Grove MN 55369-7073. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty.
Maple Grove Family Dental Clinic, Pa can be contacted via phone (763) 420-4421, or through Larson, Susan M. via phone (763) 420-4421.
Contact Information
Primary practice address
12000 Elm Creek Blvd N Suite #220
Maple Grove MN 55369-7073
Phone: (763) 420-4421
Fax: (763) 420-5674
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 9790 | Minnesota |
| Dental Providers / General Practice | 1223G0001X | 10067 | Minnesota |
| Dental Providers / General Practice | 1223G0001X | D11341 | Minnesota |
Profile Details
| NPI number | 1922181197 |
|---|---|
| LBN Legal business name | Maple Grove Family Dental Clinic, Pa |
| DBA Doing business as | |
| Authorized official | Larson, Susan M. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 23rd, 2006 |
| Last updated | Aug 22nd, 2020 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922181197 | NPPES |
| Minnesota | Other | 10656 | BLUECROSSBLUE SHIELD |
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