Organization
ZUMBRO VALLEY ENDODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL STEPHENSON (OFFICE MANAGER)
(507) 281-1295
Entity
Organization
Contact information
Practice address
2659 SUPERIOR DR NW, ROCHESTER, MN 55901-8533
(507) 281-1295
Mailing address
2659 SUPERIOR DR NW, ROCHESTER, MN 55901-8533
(507) 281-1295
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316321177
—
MN
05
—
1922101005
—
MN
Enumeration date
12/01/2020
Last updated
12/01/2020
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