TRACY M. ST. DENNIS D.D.S. PLLC NPI 1508318247

NPI Information

  • NPI: 1508318247
  • Provider Name: TRACY M. ST. DENNIS, D.D.S., PLLC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Doing Business As: WILLOW LAKE DENTAL
  • Address: 3475 WILLOW LAKE BLVD
    SUITE 100
    VADNAIS HEIGHTS, MN
    ZIP 55110
  • Phone: (651) 341-2106

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NPI Details

TRACY M. ST. DENNIS, D.D.S., PLLC is a dental clinic center in Vadnais Heights, MN. TRACY M. ST. DENNIS, D.D.S., PLLC NPI is 1508318247. The provider is registered as an organization entity type.
The provider Is Doing Business As Willow Lake Dental.

The provider's business location address is:

3475 WILLOW LAKE BLVD
SUITE 100
VADNAIS HEIGHTS, MN
ZIP 55110-156
Phone: (651) 341-2106

The provider's authorized official is Mark St Dennis .
The authorized official title is General Manager and has the following contact phone number (651) 341-2106.

The enumeration date for this NPI number is 10/28/2016 and was last updated on 10/28/2016.

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
1261QD0000XClinic/CenterDentalYes

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: 11/21/2025

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