LUNA LAND DENTAL CORP. NPI 1689181489

NPI Information

NPI: 1689181489
Provider Name: LUNA LAND DENTAL, CORP.

Doing Business As: CLEAR LAKES DENTAL

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
555 WABASHA ST N STE 250
SAINT PAUL, MN
ZIP 55102
Phone: (651) 292-9331
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LUNA LAND DENTAL, CORP. is a dental clinic center in Saint Paul, MN. LUNA LAND DENTAL, CORP. NPI is 1689181489. The provider is registered as an organization entity type.
The provider Is Doing Business As Clear Lakes Dental.

The provider's business location address is:

555 WABASHA ST N STE 250
SAINT PAUL, MN
ZIP 55102-673
Phone: (651) 292-9331

The provider's authorized official is David Ji Hyun Park .
The authorized official title is Ceo and has the following contact phone number (651) 292-9331.

The enumeration date for this NPI number is 1/3/2018 and was last updated on 1/3/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	D13905	MINNESOTA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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