| Great River Dental P.a. | |
|
375 Jackson St Saint Paul MN 55101-1810 | |
| (651) 222-0983 | |
| (651) 265-8036 |
| Full Name | Great River Dental P.a. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 375 Jackson St, Saint Paul, Minnesota |
| Authorized Official Name and Position | Jeffrey Rozinka (OWNER) |
| Authorized Official Contact | 6512220986 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great River Dental P.a. 375 Jackson St Saint Paul MN 55101-1806 Ph: (651) 222-0983 | Great River Dental P.a. 375 Jackson St Saint Paul MN 55101-1810 Ph: (651) 222-0983 |
| NPI Number | 1811972292 |
|---|---|
| Provider Enumeration Date | 12/08/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811972292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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