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General NPI Number Information
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NPI Number | 1558059022
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Entity Type | Individual
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Provider Name | ROSEMARY E SKRIVER LDH, ADT
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Gender | Female
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 3 S BROADWAY AVE
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City | GILBERT
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State | MN
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Zip | 55741-5007
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Country | US
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Telephone | 846-121-8248
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Fax |
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Provider Business Mailing Address
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Address Line | 609 NORTH CT
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City | EVELETH
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State | MN
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Zip | 55734-1431
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Country | US
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Telephone | 319-201-0099
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Fax |
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | H11405
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 125K00000X
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Taxonomy Name | Advanced Practice Dental Therapist
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License Number | DT163
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License Number State | MN
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