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NPI Code Detail

MEDICARE: DR. JONATHAN OLIVER TWOMEY D.D.S.

MEDICARE: DR. JONATHAN OLIVER TWOMEY D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0700XProsthodonticsD11235MN

General Provider Information

NPI Number : 1396883146
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHAN OLIVER TWOMEY D.D.S.
Provider Business Mailing Address
First Line : 6600 FRANCE AVE S STE 475
Second Line :
City : EDINA
State : MN
Zip : 55435-1804
Country : US
Telephone Number : 952-920-5300
Fax Number : 952-920-3799
Provider Business Practice Location Address
First Line : 6600 FRANCE AVE S STE 475
Second Line :
City : EDINA
State : MN
Zip : 55435-1804
Country : US
Telephone Number : 952-920-5300
Fax Number : 952-920-3799
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2007
Last Update Date : 10/11/2017

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