Individual
YULIYA PETUKHOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, DDS
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D14456
MN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
77495
MN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D14456
MN
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
77495
MN
Other
Enumeration date
04/10/2020
Last updated
09/09/2024
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