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Organization
AMETHYST DENTAL CARE LLC
Active
Organization
AMETHYST DENTAL CARE LLC
Active
Other names
Amethyst Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN C. BOEKER DDS (MANAGING PARTNER)
(507) 288-9288
Entity
Organization
Contact information
Practice address
1751 HIGHWAY 52 N, ROCHESTER, MN 55901-1692
(507) 282-9288
(507) 292-6622
Mailing address
1751 HIGHWAY 52 N, ROCHESTER, MN 55901-1692
(507) 282-9288
(507) 292-6622
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720073554
NPI
MN
01
—
1841286457
NPI
MN
Enumeration date
07/28/2020
Last updated
07/28/2020
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