Individual
AMBER NICHELLE IRBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MDT
Contact information
Practice address
903 W CENTER ST #130, ROCHESTER, MN 55902
(507) 529-0436
(507) 529-0435
Mailing address
3035 BRITTANY LN NW APT C, ROCHESTER, MN 55901-7012
(757) 218-8082
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
DT129
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
08/05/2020
Last updated
08/05/2020
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