MEDICARE: CIRCLE PINES FAMILY DENTAL PLLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1326921941
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CIRCLE PINES FAMILY DENTAL PLLC

Provider Business Mailing Address
First Line	:	330 GARFIELD ST S STE 330
Second Line	:
City	:	CAMBRIDGE
State	:	MN
Zip	:	55008-1772
Country	:	US
Telephone Number	:	651-470-9590
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 S PINE DR
Second Line	:
City	:	CIRCLE PINES
State	:	MN
Zip	:	55014-1798
Country	:	US
Telephone Number	:	763-786-8460
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	BARBRA CURTIS
Credential	:
Telephone Number	:	651-470-9590

Provider Enumeration Date	:	07/30/2025
Last Update Date	:	07/30/2025

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