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Organization
RUPP AND GRABOWSKI FAMILY DENTISTRY, PA
Active
Organization
RUPP AND GRABOWSKI FAMILY DENTISTRY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK GRABOWSKI DDS (OWNER)
(320) 251-1912
Entity
Organization
Contact information
Practice address
916 W SAINT GERMAIN ST, #114, SAINT CLOUD, MN 56301-3424
(320) 251-1912
(320) 251-2331
Mailing address
916 W SAINT GERMAIN ST, #114, SAINT CLOUD, MN 56301-3424
(320) 251-1912
(320) 251-2331
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12072
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386729291
—
MN
05
—
1538270442
—
MN
Enumeration date
06/21/2010
Last updated
06/21/2010
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