Organization Name: | DAKOTA CHILDREN'S DENTISTRY |
NPI Number: | 1306924584 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DANIEL H GLENN (PRESIDENT) |
Mailing Address: | 3410 151st St W Rosemount |
State: | MN US |
Postal Code: | 550681755 |
Phone Number: | 6513225788 |
Fax Number: | 6513224257 |
NPI Enumeration Date: | 11/02/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | D10462 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |