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Contact Information

ADVANCIA DENTAL
1625 RADIO DR
SUITE 170
WOODBURY, MN55125-9407
 Phone: 651-207-9660
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for ADVANCIA DENTAL

NPI Number 1124284732
LBN Legal business name ADVANCIA DENTAL
Authorized official HAITHAM MOSLY - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 08/03/2008
Last updated 08/03/2008 - About 18 years ago
Identifiers
MN License # D12156
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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