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Organization
ROGER E AUSTIN, DDS, PA
Active
Organization
ROGER E AUSTIN, DDS, PA
Active
Other names
Foley Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER E AUSTIN D.D.S. (PRESIDENT/OWNER)
(763) 757-3120
Entity
Organization
Contact information
Practice address
11237 FOLEY BLVD NW, COON RAPIDS, MN 55448-3389
(763) 757-3120
(763) 757-5161
Mailing address
11237 FOLEY BLVD NW, COON RAPIDS, MN 55448-3389
(763) 757-3120
(763) 757-5161
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
07057
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154311181
NPI ENUMERATOR FOR DAVID
MN
01
—
1184614117
NPI ENUMERATOR FOR ROGER
MN
Enumeration date
07/30/2007
Last updated
07/30/2007
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