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General NPI Number Information
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NPI Number | 1396690863
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Entity Type | Organization
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Legal Business Name | WEST END DENTAL PLLC
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 1660 HIGHWAY 100 S STE 122
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City | MINNEAPOLIS
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State | MN
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Zip | 55416-1483
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Country | US
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Telephone | 952-544-4129
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Fax |
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Provider Business Mailing Address
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Address Line | 1660 HIGHWAY 100 S STE 122
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City | MINNEAPOLIS
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State | MN
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Zip | 55416-1483
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Country | US
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Telephone | 952-544-4129
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MERISSA VELMA RICHTER MARCUSSEN
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Credential | DDS
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Telephone | 612-247-2314
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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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