Organization
TODAY'S DENTAL ROGERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUE ERICKSON (OFFICE MANAGER)
(763) 710-9937
Entity
Organization
Contact information
Practice address
21897 S DIAMOND LAKE RD STE 600, ROGERS, MN 55374-4649
(763) 657-0872
Mailing address
21897 S DIAMOND LAKE RD STE 600, ROGERS, MN 55374-4649
(763) 657-0872
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194018374
GENERAL DENTAL
MN
Enumeration date
08/15/2022
Last updated
08/15/2022
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