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Individual

DEBORRAH JANE NORDBLOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
14990 GLAZIER AVE, APPLE VALLEY, MN 55124-7818
(952) 431-5114
(952) 431-3576
Mailing address
14990 GLAZIER AVE, APPLE VALLEY, MN 55124-7818
(952) 431-5114
(952) 431-3576

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
D10101
MN
1223G0001X
General Practice Dentistry
Primary
10101
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000724372
UNITED CONCORDIA
MN
Enumeration date
01/02/2007
Last updated
08/05/2019
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