Campodonico Family & Cosmetic Dentistry PC
Dentist, General Practice in Blaine, MN. Organization (NPI-2).
NPI number1104249259
StatusActive
Last updated in NPPESJan 27, 2014
Details
- NPI
- 1104249259
- Entity type
- Organization (NPI-2)
- Legal business name
- Campodonico Family & Cosmetic Dentistry PC
- Organization subpart
- No
- Enumeration date
- Jan 27, 2014
- Last updated
- Jan 27, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | MN | Yes |
Other names
- Arden Dental Associates (Doing Business As)
Practice location
11806 Aberdeen St NeSuite 150
Blaine, MN 55449-4736
Phone 763-786-1545 · Fax 763-786-2939
Mailing address
11806 Aberdeen St NeSuite 150
Blaine, MN 55449-4736
Phone 763-786-1545 · Fax 763-786-2939
Authorized official
Carlos Ernesto Campodonico
Owner
7637861545
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