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NPI Code Detail

MEDICARE: FAMILY DENTAL CARE OF S MPLS PA

MEDICARE: FAMILY DENTAL CARE OF S MPLS PA
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 Dentistry9121MN

General Provider Information

NPI Number : 1831261510
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY DENTAL CARE OF S MPLS PA
Provider Business Mailing Address
First Line : 3152 MINNEHAHA AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-2774
Country : US
Telephone Number : 612-728-8888
Fax Number : 612-724-2737
Provider Business Practice Location Address
First Line : 3152 MINNEHAHA AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-2774
Country : US
Telephone Number : 612-728-8888
Fax Number : 612-724-2737
Authorized Official
Title or Position : PRESIDENT AND OWNER
Name : DR. KENT A CONFELD
Credential : D.D.S
Telephone Number : 612-728-8888
Provider Enumeration Date : 11/15/2006
Last Update Date : 08/22/2020

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Directions to “FAMILY DENTAL CARE OF S MPLS PA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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