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Individual

BREKKE LEE JOHNSRUD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS, MPH

Contact information

Practice address
2020 1ST AVENUE, HIBBING, MN 55746
(218) 263-8951
(218) 263-8629
Mailing address
2020 1ST AVENUE, HIBBING, MN 55746
(218) 263-8951
(218) 263-8629

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D14080
MN
1223G0001X
General Practice Dentistry
D14080
MN

Other

Enumeration date
07/04/2018
Last updated
11/19/2019
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