Organization
RUPP AND GRABOWSKI FAMILY DENTISTRY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK GRABOWSKI DDS (OWNER)
(320) 251-1912
Entity
Organization
Contact information
Practice address
916 W SAINT GERMAIN ST, #114, SAINT CLOUD, MN 56301-3424
(320) 251-1912
(320) 251-2331
Mailing address
916 W SAINT GERMAIN ST, #114, SAINT CLOUD, MN 56301-3424
(320) 251-1912
(320) 251-2331
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12072
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386729291
—
MN
05
—
1538270442
—
MN
Enumeration date
06/21/2010
Last updated
06/21/2010
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