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The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oral and Maxillofacial Surgery |
1223S0112X | 19 | Oral Surgery (Dentist only) | |
Endodontics |
1223E0200X | |||
General Practice |
1223G0001X | |||
Pediatric Dentistry |
1223P0221X | |||
Periodontics |
1223P0300X | |||
Prosthodontics |
1223P0700X |
| NPI # | 1073122321 |
| LBN Legal business name | DENTAL SPECIALIST OF MINNESOTA, PLLC |
| Authorized official | SHANNON HESSE - (CREDENTIALING SPECIALIST) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 07/23/2020 |
| Last updated | 07/23/2020 - About 6 years ago |
| Identifiers | n/a |
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DENTAL SPECIALIST OF MINNESOTA, PLLC