Organization
TODAY'S DENTAL ST.CLOUD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL ROEHLKE (OFFICE MANAGER)
(320) 774-2557
Entity
Organization
Contact information
Practice address
7960 BROOKLYN BLVD, BROOKLYN PARK, MN 55445-2722
(763) 710-9937
(763) 710-9968
Mailing address
4128 2ND ST S, SAINT CLOUD, MN 56301-3704
(320) 774-2557
(763) 710-9968
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
D12960
MN
Other
Enumeration date
01/27/2015
Last updated
09/09/2020
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