Cosmetic, Family & Sports Dentistry, PA
Dentist, General Practice in Edina, MN. Organization (NPI-2).
NPI number1164546040
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1164546040
- Entity type
- Organization (NPI-2)
- Legal business name
- Cosmetic, Family & Sports Dentistry, PA
- Organization subpart
- No
- Enumeration date
- Mar 18, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
6545 France Ave SSuite 585
Edina, MN 55435-2131
Phone 952-922-9119 · Fax 952-922-2628
Mailing address
6545 France Ave SSuite 585
Edina, MN 55435-2131
Phone 952-922-9119 · Fax 952-922-2628
Authorized official
Douglas Lee Lambert
Owner
9529229119
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