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Contact Information

ADVANCED DENTAL GROUP
3909 SILVER LAKE RD NE
MINNEAPOLIS, MN55421-4352
 Phone: 612-789-3573
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Periodontics

1223P0300X
Indicates primary specialty

NPI Profile & details for ADVANCED DENTAL GROUP

NPI # 1275707580
LBN Legal business name ADVANCED DENTAL GROUP
Authorized official RAYMOND HELLICKSON - (DENTIST/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/17/2008
Last updated 04/17/2008 - About 18 years ago
Identifiers
MN License # D10650
MN License # D11408
MN License # D6670
MN License # D7712
MN License # D7910
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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