MEDICARE: ADELMANN DENTISTRY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	10008	MN

General Provider Information

NPI Number	:	1528423274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADELMANN DENTISTRY LLC

Provider Business Mailing Address
First Line	:	14247 OCONNELL CT
Second Line	:	100
City	:	SAVAGE
State	:	MN
Zip	:	55378-2878
Country	:	US
Telephone Number	:	952-226-3560
Fax Number	:	952-226-3562

Provider Business Practice Location Address
First Line	:	14247 OCONNELL CT
Second Line	:	100
City	:	SAVAGE
State	:	MN
Zip	:	55378-2878
Country	:	US
Telephone Number	:	952-226-3560
Fax Number	:	952-226-3562

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	DR. CRAIG ADELMANN
Credential	:	DDS
Telephone Number	:	952-226-3560

Provider Enumeration Date	:	12/23/2015
Last Update Date	:	12/23/2015

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Directions to “ADELMANN DENTISTRY LLC ” Practice Location

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