Ideal Dental Pllc

LBN: Ideal Dental Pllc
Ideal Dental Pllc is an health care organization with primary practice located at 2130 Cliff Rd Ste 107 , Eagan MN 55122-2486. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Ideal Dental Pllc can be contacted via phone (651) 452-3112, or through Anderson, Trent Mitchel via phone (651) 353-6651.

Contact Information

Primary practice address
2130 Cliff Rd Ste 107 Eagan MN 55122-2486
Phone: (651) 452-3112
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Anderson, Trent Mitchel Doctor of Dental Surgery (DDS)
Phone: (651) 353-6651

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X

Profile Details

NPI number 1730734708
LBN Legal business name Ideal Dental Pllc
DBA Doing business as
Authorized official Anderson, Trent Mitchel Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 7th, 2019
Last updated Aug 7th, 2019 - about 7 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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Identifiers

StateTypeNumberIssuer
All States NPI 1730734708 NPPES
Minnesota MEDICAID 1689663148

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