Organization
ROCHESTER PEDIATRIC DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY AMANDA JONES D.D.S. (PEDIATRIC DENTIST, OWNER)
(608) 206-1233
Entity
Organization
Contact information
Practice address
1705 S BORADWAY AVE STE B, ROCHESTER, MN 55904-7960
(507) 288-0102
(507) 252-1445
Mailing address
1705 S BORADWAY AVE STE B, ROCHESTER, MN 55904-7960
(507) 288-0102
(507) 252-1445
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
D13120
MN
1223P0221X
Pediatric Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/16/2014
Last updated
12/08/2020
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