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Organization
ROSEVILLE DENTISTRY
Active
Organization
ROSEVILLE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI JO DULIN RDA (OFFICE MANAGER)
(651) 631-3610
Entity
Organization
Contact information
Practice address
1912 LEXINGTON AVE N, SUITE 200, ROSEVILLE, MN 55113-6113
(651) 631-3610
(651) 631-1626
Mailing address
1912 LEXINGTON AVE. N., SUITE 200, ROSEVILLE, MN 55113
(651) 631-3610
(651) 631-1626
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/01/2009
Last updated
05/01/2009
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