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General NPI Number Information
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NPI Number | 1952712366
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Entity Type | Organization
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Legal Business Name | REGENTS OF THE UNIVERSITY OF MINNESOTA
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Dates
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Enumeration Date | 05/20/2014
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Last Update Date | 05/20/2014
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Provider Practice Location Address
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Address Line | 515 DELAWARE ST SE 7-530 MOOS TOWER
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City | MINNEAPOLIS
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State | MN
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Zip | 55455-0369
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Country | US
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Telephone | 613-262-6423
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Fax | 612-626-1972
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Provider Business Mailing Address
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Address Line | 515 DELAWARE ST SE 7-530 MOOS TOWER
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City | MINNEAPOLIS
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State | MN
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Zip | 55455-0369
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Country | US
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Telephone | 613-262-6423
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Fax | 612-626-1972
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | MR. JEFFREY S. OGDEN
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Credential |
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Telephone | 612-624-6624
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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 |
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License Number State | MN
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