Healthcare Provider Details

I. General information

NPI: 1821099748
Provider Name (Legal Business Name): DENNIS ARTHUR WOOLNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 03/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 OAKDALE AVE N
ROBBINSDALE MN
55422-2926
US

IV. Provider business mailing address

2800 CAMPUS DR #10
PLYMOUTH MN
55441-2645
US

V. Phone/Fax

Practice location:
  • Phone: 763-559-2171
  • Fax: 763-694-9000
Mailing address:
  • Phone: 763-559-2171
  • Fax: 763-694-9000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number43268
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number43268
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number43268
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: