Provider Demographics
NPI:1376687103
Name:KILLIAN & MILNAR DENTISTRY PLLC
Entity type:Organization
Organization Name:KILLIAN & MILNAR DENTISTRY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:KILLIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:651-645-6111
Mailing Address - Street 1:PO BOX 4520
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-0520
Mailing Address - Country:US
Mailing Address - Phone:651-645-6111
Mailing Address - Fax:651-645-6014
Practice Address - Street 1:11806 ABERDEEN ST NE
Practice Address - Street 2:SUITE 150
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-4736
Practice Address - Country:US
Practice Address - Phone:763-786-1545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty