Individual
MRS. BRIEANNE KELSEY BORNTRAGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ADT
Contact information
Practice address
13899 HWY 13 S FRNT RD, SAVAGE, MN 55378-2135
(763) 218-0597
Mailing address
13899 HWY 13 S FRNT RD, SAVAGE, MN 55378-2135
(763) 218-0597
Taxonomy
Speciality
Code
Description
License number
State
125K00000X
Advanced Practice Dental Therapist
Primary
DT15
MN
Other
Enumeration date
05/03/2012
Last updated
04/07/2016
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