Organization
JAMES ROSTVOLD
Active
Other names
West Range Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY MORRIS LDA (FRONT DESK)
(218) 326-2560
Entity
Organization
Contact information
Practice address
1043 E US HIGHWAY 169, GRAND RAPIDS, MN 55744-3165
(218) 326-2560
(218) 326-8256
Mailing address
PO BOX 339, GRAND RAPIDS, MN 55744-0339
(218) 326-2560
(218) 326-8256
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
872720100
—
MN
Enumeration date
03/17/2022
Last updated
03/17/2022
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