Individual
KERRY GWEN JOHNSON WINTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3410 151ST ST W, ROSEMOUNT, MN 55068-1755
(651) 322-5788
(651) 322-4257
Mailing address
3410 151ST ST W, ROSEMOUNT, MN 55068-1755
(651) 322-5788
(651) 322-4257
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D11777
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
380650200
—
MN
Enumeration date
01/27/2006
Last updated
11/30/2012
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