Organization
SORENSON DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT S SORENSON (OWNER)
(651) 204-0201
Entity
Organization
Contact information
Practice address
14688 EVERTON AVE N, SUITE 104, HUGO, MN 55038-6064
(651) 204-0201
Mailing address
14688 EVERTON AVE N, SUITE 104, HUGO, MN 55038-6064
(651) 204-0201
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D13363
MN
Other
Enumeration date
04/24/2017
Last updated
04/24/2017
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