Provider First Line Business Practice Location Address:
2218 LAUREL AVE
Provider Second Line Business Practice Location Address:
MILL CITY DENTAL
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55405-1909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-377-3740
Provider Business Practice Location Address Fax Number:
612-377-5004
Provider Enumeration Date:
12/07/2005