Lifelong Dental Care
Clinic/Center, Dental in West St Paul, MN. Organization (NPI-2).
NPI number1689286015
StatusActive
Last updated in NPPESAug 18, 2020
Details
- NPI
- 1689286015
- Entity type
- Organization (NPI-2)
- Legal business name
- Lifelong Dental Care
- Organization subpart
- No
- Enumeration date
- Aug 18, 2020
- Certification date
- Aug 18, 2020
- Last updated
- Aug 18, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
1525 Livingston Ave Ste BWest St Paul, MN 55118-3430
Phone 651-457-4888
Mailing address
1525 Livingston Ave Ste BWest St Paul, MN 55118-3430
Phone 651-457-4888
Authorized official
Denyce Jones
Office Manager
6513193546
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