Maple Grove Family Dental Clinic, Pa
Dental Clinic
12000 Elm Creek Blvd N, Suite #220, Maple Grove
Minnesota, 55369-7073
763-420-4421 763-420-5674
Maps & DirectionsMaple Grove Family Dental Clinic, Pa is a Dental Clinic in Maple Grove, Minnesota. It is located at 12000 Elm Creek Blvd N, Suite #220, Maple Grove, MN and its contact number is 763-420-4421. The authorized person for Maple Grove Family Dental Clinic, Pa is Ms. Susan M. Larson
who is Clinic Administrator of the clinic and their contact number is 763-420-4421. Other organizations associated with this clinic are Maple Grove Periodontics And Implant Dentistry, Maple Grove Family Dental Clinic, Pa, The primary license number for Maple Grove Family Dental Clinic, Pa is D11341 (General Practice) in Minnesota.
Maple Grove Family Dental Clinic, Pa Clinic caters to patients of all ages for their dental care needs. Dentists at the clinic are responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Clinic Profile:
Maple Grove Family Dental Clinic, Pa Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Maple Grove Family Dental Clinic, Pa |
| Specialization: | General Practice Dentistry |
| Clinic Address: | 12000 Elm Creek Blvd N, Suite #220, Maple Grove,
Minnesota, 55369-7073 |
| Phone: | 763-420-4421 |
| Fax: | 763-420-5674 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Ms. Susan M. Larson |
| Position: | Clinic Administrator |
| Contact Number: | 763-420-4421 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Maple Grove Family Dental Clinic, Pa clinic are as mentioned below.
| NPI Number: | 1922181197 |
| NPI Enumeration Date: | 23 Oct, 2006 |
| NPI Last Update On: | 22 Aug, 2020 |
Other Associated Organizations:
Other organizations which are associated with this clinic are as mentioned below. These organization share the same address but have similar or different specialization.
Speciality of these organizations are also mentioned below.
| Name | Specialization | NPI Number |
| Maple Grove Periodontics And Implant Dentistry | Periodontology | 1891295861 |
| Maple Grove Family Dental Clinic, Pa | General Practice Dentistry | 1922181197 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Maple Grove Family Dental Clinic, Pa are as mentioned below.
| Specialization | License Number | State | Status | |
| General Practice | D11341 | Minnesota | Primary | |
| General Practice | 9790 | Minnesota | Secondary | |
| General Practice | 10067 | Minnesota | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 10656 | Other | Minnesota | Bluecrossblue Shield |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Maple Grove Family Dental Clinic, Pa
12000 Elm Creek Blvd N, Suite #220
Maple Grove, Minnesota |
| Zip: | 55369-7073 |
| Phone Number: | 763-420-4421 |
| Fax Number: | 763-420-5674 |
Patients can reach Maple Grove Family Dental Clinic, Pa at
12000 Elm Creek Blvd N, Suite #220, Maple Grove, Minnesota or can
call to book an appointment on 763-420-4421.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.