G2 South
Dentist in Inver Grove Heights, MN. Organization (NPI-2).
NPI number1821079583
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1821079583
- Entity type
- Organization (NPI-2)
- Legal business name
- G2 South
- Organization subpart
- No
- Enumeration date
- Nov 9, 2005
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 8109 | MN | Yes |
| 122300000X | Dentist | 9975 | MN |
Practice location
5846 Blackshire PathInver Grove Heights, MN 55016
Phone 651-389-1133 · Fax 651-389-1135
Mailing address
5846 Blackshire PathInver Grove Heights, MN 55016
Phone 651-389-1133 · Fax 651-389-1135
Authorized official
Tracey M Koctt
Practice Manager
6513891133
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Other Dentist providers in Inver Grove Heights, MN
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- G2 South PLLCNPI 1023127388
- Scott Robert Graham, DDSNPI 1881320547
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All 18 Dentist providers in Inver Grove Heights · All 472 providers in Inver Grove Heights
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