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Contact Information

COMMUNITY DENTAL CARE
1670 BEAM AVE
MAPLEWOOD, MN55109-1201
 Phone: 651-925-8400
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Point of Service

305S00000X
Indicates primary specialty

NPI Profile & details for COMMUNITY DENTAL CARE

NPI # 1992102040
LBN Legal business name COMMUNITY DENTAL CARE
Authorized official VACHAREE PETERSON - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 12/04/2014
Last updated 12/04/2014 - About 12 years ago
Identifiers
MN License # H9154
MN Medicaid 124Q00000X
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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