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General NPI Number Information
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NPI Number | 1720329535
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Entity Type | Organization
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Legal Business Name | MINNESOTA DENTAL CENTER
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Dates
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Enumeration Date | 03/05/2013
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Last Update Date | 03/05/2013
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Provider Practice Location Address
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Address Line | 17601 HIGHWAY 7 #200
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City | MINNETONKA
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State | MN
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Zip | 55345-4104
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Country | US
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Telephone | 651-738-1880
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Fax |
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Provider Business Mailing Address
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Address Line | 17601 HIGHWAY 7 #200
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City | MINNETONKA
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State | MN
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Zip | 55345-4104
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Country | US
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Telephone | 651-738-1880
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. HOLGER P MEISER
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Credential | D.D.S.
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Telephone | 651-208-9389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D12130
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License Number State | MN
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