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General NPI Number Information
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NPI Number | 1346065398
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Entity Type | Organization
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Legal Business Name | APPLE TREE DENTAL
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Dates
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Enumeration Date | 11/15/2024
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 450 SYNDICATE ST N STE 119
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City | SAINT PAUL
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State | MN
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Zip | 55104-4127
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Country | US
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Telephone | 651-644-8882
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Fax | 651-644-7976
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Provider Business Mailing Address
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Address Line | 2201 26TH AVE NW
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City | NEW BRIGHTON
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State | MN
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Zip | 55112-5005
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | NANCY SCHUMACHER
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Credential |
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Telephone | 763-600-6839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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