Gina Marie Buchal, ADT
Dental Therapist in New Hope, MN. Individual provider (NPI-1).
NPI number1073026514
StatusActive
Last updated in NPPESNov 7, 2017
Details
- NPI
- 1073026514
- Entity type
- Individual (NPI-1)
- Name
- Gina Marie Buchal
- Credential
- ADT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 7, 2017
- Last updated
- Nov 7, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 125J00000X | Dental Therapist | DT52 | MN | Yes |
Practice location
5001 Winnetka Ave NNew Hope, MN 55428-4230
Phone 763-533-0055 · Fax 763-533-0057
Mailing address
4100 Shoreline Dr Ste 4Spring Park, MN 55384-4527
Phone 952-224-9775 · Fax 952-224-9774
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