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General NPI Number Information
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NPI Number | 1467819573
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Entity Type | Organization
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Legal Business Name | NORTH POINTE DENTAL
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Dates
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Enumeration Date | 01/20/2016
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Last Update Date | 01/20/2016
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Provider Practice Location Address
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Address Line | 2647 SUPERIOR DR NW STE 200
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City | ROCHESTER
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State | MN
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Zip | 55901-8523
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Country | US
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Telephone | 507-281-3548
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Fax |
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Provider Business Mailing Address
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Address Line | 2647 SUPERIOR DR NW STE 200
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City | ROCHESTER
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State | MN
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Zip | 55901-8523
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Country | US
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Telephone | 507-281-3548
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JASON M TONEY
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Credential | DDS
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Telephone | 507-281-3548
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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 | 11813
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License Number State | MN
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