THE DENTAL SPECIALIST OF MINNESOTA PLLC NPI 1265097653

NPI Information

  • NPI: 1265097653
  • Provider Name: THE DENTAL SPECIALIST OF MINNESOTA, PLLC
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Address: 13961 60TH ST N
    STILLWATER, MN
    ZIP 55082
  • Phone: (651) 760-3681

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NPI Details

THE DENTAL SPECIALIST OF MINNESOTA, PLLC is an oral and maxillofacial surgery dentist in Stillwater, MN. The provider is an oral and maxillofacial surgery dentist specialized in 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. THE DENTAL SPECIALIST OF MINNESOTA, PLLC NPI is 1265097653. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

13961 60TH ST N
STILLWATER, MN
ZIP 55082-053
Phone: (651) 760-3681
Fax: (651) 760-3683

The provider's authorized official is Shannon Hesse .
The authorized official title is Credentialing Specialist and has the following contact phone number (651) 746-2815.

The enumeration date for this NPI number is 5/1/2019 and was last updated on 10/28/2020.

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
11223S0112XDentistOral and Maxillofacial SurgeryYes

What is NPI?

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This page was last updated on: 3/30/2025

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