123 Brush Dental Llc

LBN: 123 Brush Dental Llc
123 Brush Dental Llc is an health care organization with primary practice located at 1670 Beam Ave Ste 202, Maplewood MN 55109. The organization recently has only one registered license in Ambulatory Health Care Facilities / Dental, which is considered as the primary health care specialty. 123 Brush Dental Llc can be contacted via phone (651) 779-4195, or through Peterson, Vacharee Sriswad via phone (651) 779-4195.

Contact Information

Primary practice address
1670 Beam Ave Ste 202 Maplewood MN 55109
Phone: (651) 779-4195
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Peterson, Vacharee Sriswad Doctor of Dental Surgery (DDS)
Phone: (651) 779-4195

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Dental 261QD0000X D9309 Minnesota

Profile Details

NPI number 1053807016
LBN Legal business name 123 Brush Dental Llc
DBA Doing business as
Authorized official Peterson, Vacharee Sriswad Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 2nd, 2018
Last updated Jul 2nd, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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