Glen Oaks Dental PLLP

Organization Active NPI General Practice Dentistry · Circle Pines, MN

NPI 1710054986 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1710054986
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
D8945 (MN)
Legal business name
GLEN OAKS DENTAL PLLP
Practice address
2 S Pine Dr
Ste M
Circle Pines, MN 55014-1798
Phone
(763) 786-8460
Fax
(763) 786-1792
NPI assigned
Nov 30, 2006
Organization subpart
No

Authorized official

Name
Dr. Paul David Craven, DDS
Title
General Partner
Phone
(763) 786-8460

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

2 S Pine Dr
Ste M
Circle Pines, MN 55014
Phone (763) 786-8460

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X D8945 MN Yes

Addresses

Primary practice location

2 S Pine Dr
Ste M
Circle Pines, MN 55014-1798

Mailing address

2 S Pine Dr
Ste M
Circle Pines, MN 55014-1848
Phone (763) 786-8460

Other providers in Circle Pines, MN

All providers in Circle Pines, MN · General Practice Dentistry in Minnesota

Sources for this page

Verify at the official NPI Registry.