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General NPI Number Information
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NPI Number | 1235564725
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Entity Type | Organization
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Legal Business Name | DENTISTRY BY DESIGN
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Dates
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Enumeration Date | 09/04/2013
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Last Update Date | 09/04/2013
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Provider Practice Location Address
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Address Line | 17809 HUTCHINS DR 108
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City | MINNETONKA
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State | MN
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Zip | 55345-4100
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Country | US
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Telephone | 952-474-5041
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Fax | 952-401-1608
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Provider Business Mailing Address
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Address Line | 17809 HUTCHINS DR 108
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City | MINNETONKA
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State | MN
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Zip | 55345-4100
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Country | US
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Telephone | 952-474-5041
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Fax | 952-401-1608
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Authorized Official
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Title or Position | FRONT DESK
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Name | MRS. JOCELYN SCHWARTZ
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Credential |
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Telephone | 952-474-5041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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