Individual
DR. BETH RENEE GROENKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
7600 FRANCE AVE S STE 100, EDINA, MN 55435-5924
(888) 964-6681
Mailing address
406 WACOUTA ST UNIT 713, SAINT PAUL, MN 55101-2054
(816) 813-7212
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2013016374
MO
122300000X
Dentist
204120
CO
122300000X
Dentist
Primary
D14665
MN
1223X2210X
Orofacial Pain Dentistry
2013016374
MO
1223X2210X
Orofacial Pain Dentistry
204120
CO
1223X2210X
Orofacial Pain Dentistry
D14665
MN
Other
Enumeration date
06/24/2013
Last updated
10/27/2021
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