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NPI Code Detail

MEDICARE: DR. MARC DANA ORJANSEN DDS, MS

MEDICARE:  DR. MARC DANA ORJANSEN  DDS, MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0300XPeriodonticsD11296MN

General Provider Information

NPI Number : 1194813808
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARC DANA ORJANSEN DDS, MS
Provider Business Mailing Address
First Line : 1511 NORTHWAY DR
Second Line : SUITE 202
City : SAINT CLOUD
State : MN
Zip : 56303-1261
Country : US
Telephone Number : 320-240-9028
Fax Number : 320-240-9048
Provider Business Practice Location Address
First Line : 1511 NORTHWAY DR
Second Line : SUITE 202
City : SAINT CLOUD
State : MN
Zip : 56303-1261
Country : US
Telephone Number : 320-240-9028
Fax Number : 320-240-9048
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 07/08/2007

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