Organization
GLK ORTHODONTICS PA
Active
Organization
GLK ORTHODONTICS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI KUBALL (ADMIN & FINANCIAL COORDINATOR)
(507) 281-3121
Entity
Organization
Contact information
Practice address
1705 BROADWAY AVE S STE A, ROCHESTER, MN 55904-7973
(507) 288-4427
(507) 288-8497
Mailing address
1705 BROADWAY AVE S STE A, ROCHESTER, MN 55904-7960
(507) 288-4427
(507) 288-8497
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
03/15/2007
Last updated
05/27/2021
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