Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Minnesota Craniofacial Center PC

Organization Clinic/Center · NPI 1104160480

Minnesota Craniofacial Center PC is a Clinic/Center in Saint Paul, Minnesota. Licensed in Minnesota. Registered with an NPI since 2012.

Licensed in
MN
In the registry since
2012
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2550 University Ave W Ste 143N
Saint Paul, MN 55114-1052
Phone: (651) 642-1013
Fax: (651) 642-0947
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X · Licence 11715 (MN)

Record details

NPI number1104160480
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kim Ledermann — Dentist/Owner · (651) 642-1013
NPI enumeratedNovember 26, 2012
Last updated in NPPESJune 11, 2015
Mailing address2550 University Ave W, Suite 143n, Saint Paul, MN 55114-1052

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