Organization
ROSSODONTICS DENTAL SLEEP MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY KENT ROSS D.D.S. (OWNER)
(651) 207-9400
Entity
Organization
Contact information
Practice address
368 LAKE ST S STE 101, FOREST LAKE, MN 55025-2824
(651) 464-6988
Mailing address
368 LAKE ST S STE 101, FOREST LAKE, MN 55025-2824
(651) 464-6988
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
11/18/2013
Last updated
01/04/2024
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