Provider Demographics
NPI:1689957888
Name:MINNESOTA SEDATION DENTAL
Entity Type:Organization
Organization Name:MINNESOTA SEDATION DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:763-689-5501
Mailing Address - Street 1:1596 2ND AVE NE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MN
Mailing Address - Zip Code:55008
Mailing Address - Country:US
Mailing Address - Phone:763-689-5501
Mailing Address - Fax:763-210-5272
Practice Address - Street 1:1596 2ND AVE NE
Practice Address - Street 2:SUITE B
Practice Address - City:CAMBRIDGE
Practice Address - State:MN
Practice Address - Zip Code:55008
Practice Address - Country:US
Practice Address - Phone:763-689-5501
Practice Address - Fax:763-210-5272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-23
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental