| Organization Name: | CENTURY COLLEGE DENTAL HYGIENE PROGRAM |
| NPI Number: | 1043509425 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LINDA MARIE JORGENSON (PROGRAM DIRECTOR) |
| Mailing Address: | 3300 Century Ave N East Campus - Dental Clinic White Bear Lake |
| State: | MN US |
| Postal Code: | 551101842 |
| Phone Number: | 6517793983 |
| Fax Number: | 6517793401 |
| NPI Enumeration Date: | 04/06/2011 |
| NPI Last Update Date: | 04/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | H1557 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |