Organization
A GENTLE DENTAL CENTER OF ROGERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JILL PUCEL KOOPMAN D.D.S. (OWNER)
(763) 428-2226
Entity
Organization
Contact information
Practice address
14115 JAMES RD, SUITE 303, ROGERS, MN 55374-9468
(763) 428-2226
(763) 428-3407
Mailing address
14115 JAMES RD, SUITE 303, ROGERS, MN 55374-9468
(763) 428-2226
(763) 428-3407
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11666
MN
Other
Enumeration date
11/09/2006
Last updated
08/22/2020
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