Shepard Family Dentistry, P.C.
Clinic/Center, Dental in Coon Rapids, MN. Organization (NPI-2).
NPI number1982305454
StatusActive
Last updated in NPPESMar 13, 2023
Details
- NPI
- 1982305454
- Entity type
- Organization (NPI-2)
- Legal business name
- Shepard Family Dentistry, P.C.
- Organization subpart
- No
- Enumeration date
- Mar 13, 2023
- Certification date
- Mar 13, 2023
- Last updated
- Mar 13, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
3911 Coon Rapids Blvd NwCoon Rapids, MN 55433-2520
Phone 763-421-0770 · Fax 763-421-0772
Mailing address
3911 Coon Rapids Blvd NwCoon Rapids, MN 55433-2520
Phone 763-421-0770
Authorized official
Clayton Roland Shepard
Dentist
7634210770
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