| 12th Street Dental Office Pa | |
|
1008 12th Street Se Rochester MN 55904-5030 | |
| (507) 282-6448 | |
| (507) 287-8846 |
| Full Name | 12th Street Dental Office Pa |
|---|---|
| Speciality | Dentist |
| Location | 1008 12th Street Se, Rochester, Minnesota |
| Authorized Official Name and Position | Joseph Gerard Becker (OWNER PARTNER DENTIST) |
| Authorized Official Contact | 5072826448 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 12th Street Dental Office Pa 1008 12th Street Se Rochester MN 55904-5030 Ph: (507) 282-6448 | 12th Street Dental Office Pa 1008 12th Street Se Rochester MN 55904-5030 Ph: (507) 282-6448 |
| NPI Number | 1043374176 |
|---|---|
| Provider Enumeration Date | 12/21/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043374176 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | MN9567 (Minnesota) | Primary |
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