MEDICARE: TOWN DENTAL, PA

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	D11057	MN

General Provider Information

NPI Number	:	1639398886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOWN DENTAL, PA

Provider Business Mailing Address
First Line	:	700 WESTON RIDGE PKWY
Second Line	:
City	:	CHASKA
State	:	MN
Zip	:	55318-1202
Country	:	US
Telephone Number	:	952-368-3356
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 2ND ST
Second Line	:
City	:	EXCELSIOR
State	:	MN
Zip	:	55331-2038
Country	:	US
Telephone Number	:	952-474-6133
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	DR. DAVID J HARVIEUX
Credential	:	DENTIST
Telephone Number	:	952-474-6133

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1487643706 — DAVID HARVIEUX DDS
Practice Location Address:

425 2ND ST
EXCELSIOR, MN
55331-2038

Practice Phone: 952-474-6133
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1093704124 — CHRISTOPHER M JOHNSON DDS
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1962460881 — TOWN DENTAL, PA
Practice Location Address:

425 2ND ST
EXCELSIOR, MN
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1962402834 — MICHAEL T SCHULENBERG MD
Practice Location Address:

675 WATER ST
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1487647137 — MR. MICHAEL JAMES ISAACSON DC
Practice Location Address:

24000 HIGHWAY 7 , STE 215
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1548256530 — NEWTON H JOHNSON
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Directions to “TOWN DENTAL, PA ” Practice Location

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