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NPI 1144380627

NPI 1144380627 : SCOTT WILLIAM RINGDAHL DR DENTIST : GLENWOOD, MN

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General NPI Number Information
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    NPI Number           |    1144380627
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    Entity Type          |    Individual 
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    Provider Name        |    SCOTT WILLIAM RINGDAHL DR DENTIST
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/12/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1616 N FRANKLIN STR 
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    City                 |    GLENWOOD
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    State                |    MN
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    Zip                  |    56334
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    Country              |    US
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    Telephone            |    320-634-3556
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    Fax                  |    320-634-3567
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Provider Business Mailing Address
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    Address Line         |    PO BOX 213 1616 N FRANKLIN STR
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    City                 |    GLENWOOD
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    State                |    MN
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    Zip                  |    56334
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    Country              |    US
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    Telephone            |    320-634-3556
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    Fax                  |    320-634-3567
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    D9801
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    License Number State |    MN
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