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15243 Nowthen Blvd Nw Ramsey MN 55303-6138 | |
| (763) 421-2660 | |
| (763) 421-2661 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 15243 Nowthen Blvd Nw, Ramsey, Minnesota |
| Authorized Official Name and Position | Roger E Austin (PRESIDENT/OWNER) |
| Authorized Official Contact | 7634212660 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
15243 Nowthen Blvd Nw Ramsey MN 55303-6138 Ph: (763) 421-2660 | 15243 Nowthen Blvd Nw Ramsey MN 55303-6138 Ph: (763) 421-2660 |
| NPI Number | 1225229503 |
|---|---|
| Provider Enumeration Date | 08/05/2007 |
| Last Update Date | 08/05/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225229503 | NPI | - | NPPES |
| 1184614117 | Other | NPI ENUMERATOR FOR ROGER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 07057 (Minnesota) | Primary |
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Minnesota Dental Professionals, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 15243 Nowthen Blvd Nw, Ramsey, MN 55303 Phone: 763-421-2660 | |
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