Organization
WYOMING DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW L ROHLF DDS (OWNER)
(651) 462-5150
Entity
Organization
Contact information
Practice address
5378 E VIKING BLVD, WYOMING, MN 55092
(651) 462-5150
(651) 462-1092
Mailing address
PO BOX 189, WYOMING, MN 55092-0189
(651) 462-5150
(651) 462-1092
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
07/07/2022
Last updated
07/18/2022
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