| Periodontal Specialists, Pa | |
|
2112 Viking Dr Nw Rochester MN 55901-3522 | |
| (507) 288-1338 | |
| Not Available |
| Full Name | Periodontal Specialists, Pa |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 2112 Viking Dr Nw, Rochester, Minnesota |
| Authorized Official Name and Position | Tanyia Bucher (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 5074518151 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Periodontal Specialists, Pa 2112 Viking Dr Nw Rochester MN 55901-3522 Ph: (507) 288-1338 | Periodontal Specialists, Pa 2112 Viking Dr Nw Rochester MN 55901-3522 Ph: (507) 288-1338 |
| NPI Number | 1740359546 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740359546 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 07829 (Minnesota) | Primary |
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