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NPI Code Detail

MEDICARE: NORTHLAND DENTAL PARTNERS

MEDICARE: NORTHLAND DENTAL PARTNERS
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
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1770730954
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHLAND DENTAL PARTNERS
Provider Business Mailing Address
First Line : 3030 CENTRE POINTE DR
Second Line :
City : ROSEVILLE
State : MN
Zip : 55113-1112
Country : US
Telephone Number : 651-286-8100
Fax Number :
Provider Business Practice Location Address
First Line : 1905 PLAZA DR
Second Line :
City : EAGAN
State : MN
Zip : 55122-2883
Country : US
Telephone Number : 651-686-6678
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : JAMES LUDKE
Credential : DDS
Telephone Number : 651-286-8100
Provider Enumeration Date : 08/19/2008
Last Update Date : 08/19/2008

Similar Medicare Providers

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Practice Location Address:
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55122-2883
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1932269388 — DR. KATHERINE CAROLINE KOTTAS DDS
Practice Location Address:
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1043370414 — DR. JACOBI LAZAR LUDWIG DDS
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1114074572 — DR. NICHOLAS S GELLER DDS
Practice Location Address:
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Directions to “NORTHLAND DENTAL PARTNERS ” Practice Location

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