Healthcare Provider Details

I. General information

NPI: 1366422909
Provider Name (Legal Business Name): SONYA JOSEPHS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 43RD ST NW
ROCHESTER MN
55901-5847
US

IV. Provider business mailing address

3000 43RD ST NW
ROCHESTER MN
55901-5847
US

V. Phone/Fax

Practice location:
  • Phone: 507-287-8320
  • Fax: 507-281-8747
Mailing address:
  • Phone: 507-287-8320
  • Fax: 507-281-8747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberD11570
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: