Individual
DR. NICHOLAS PHILIP BRONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
800 MARIE AVE, SOUTH SAINT PAUL, MN 55075-2055
(651) 451-1277
Mailing address
800 MARIE AVE, SOUTH SAINT PAUL, MN 55075-2055
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D13138
MN
Other
Enumeration date
07/10/2012
Last updated
07/10/2012
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