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General NPI Number Information
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NPI Number | 1386372597
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Entity Type | Organization
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Legal Business Name | TODAY'S DENTAL ROGERS LLC
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Dates
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Enumeration Date | 08/15/2022
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Last Update Date | 08/15/2022
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Provider Practice Location Address
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Address Line | 21897 S DIAMOND LAKE RD STE 600
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City | ROGERS
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State | MN
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Zip | 55374-4649
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Country | US
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Telephone | 763-657-0872
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Fax |
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Provider Business Mailing Address
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Address Line | 21897 S DIAMOND LAKE RD STE 600
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City | ROGERS
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State | MN
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Zip | 55374-4649
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Country | US
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Telephone | 763-657-0872
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. JACQUE ERICKSON
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Credential |
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Telephone | 763-710-9937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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