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Organization

GOSSAI & KNUTSON, DDS, PA

Active
Other names
Southill Dental Group PA
Organization subpart
No

Provider details

NPI number
Authorized official
DONNA KOBS (OFFICE MANAGER)
(651) 439-9400
Entity
Organization

Contact information

Practice address
2850 CURVE CREST BLVD W, SUITE 200, STILLWATER, MN 55082-4039
(651) 439-9400
(651) 439-9402
Mailing address
2850 CURVE CREST BLVD W, SUITE 200, STILLWATER, MN 55082-4039
(651) 439-9400
(651) 439-9402

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12778
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1184616005
NPI - FLODIN
MN
01
1477692903
NPI KNUTSON
05
1477692903
MN
01
1831419209
NPI GOSSAI
05
1831419209
MN
01
18386
H. PARTNER ID - FLODIN
MN
05
293218100
MN
05
9909
MN
Enumeration date
04/25/2007
Last updated
04/02/2013
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