Shana Marie Buerck, LDH, DT

Individual provider Active NPI Dental Therapist · Mounds View, MN

NPI 1265213441 · NPPES record last updated Oct 12, 2023

Key facts

NPI
1265213441
Entity type
Individual (NPI type 1)
Primary specialty
Dental Therapist 125J00000X
License
DT159 (MN)
Practice address
2442 County Hwy 10
Mounds View, MN 55112
Phone
(763) 316-5400
NPI assigned
Oct 12, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DT159MNMDDental Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Therapist 125J00000X DT159 MN Yes

Addresses

Primary practice location

2442 County Hwy 10
Mounds View, MN 55112

Mailing address

108 Bichner LN
Mahtomedi, MN 55115-6810
Phone (651) 983-1429

Other names

  • Ms. Shana Marie Atkinson Former name

Other providers in Mounds View, MN

All providers in Mounds View, MN · Dental Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.