Healthcare Provider Details

I. General information

NPI: 1902140205
Provider Name (Legal Business Name): UNITED FAMILY PRACTICE HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2012
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 7TH ST W
SAINT PAUL MN
55102-3828
US

IV. Provider business mailing address

1026 7TH ST W
SAINT PAUL MN
55102-3828
US

V. Phone/Fax

Practice location:
  • Phone: 651-241-1000
  • Fax: 651-241-1138
Mailing address:
  • Phone: 651-241-1000
  • Fax: 651-241-1138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LORI ANN ZOOK
Title or Position: CFO
Credential:
Phone: 651-758-9500