| Thomas L. Sitzer, D.d.s., P.a. | |
|
2112 Viking Dr Nw Valhalla Dental Building Rochester MN 55901-3522 | |
| (507) 288-0102 | |
| (507) 288-2243 |
| Full Name | Thomas L. Sitzer, D.d.s., P.a. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2112 Viking Dr Nw, Rochester, Minnesota |
| Authorized Official Name and Position | Thomas Lyman Sitzer (OWNER) |
| Authorized Official Contact | 5072880102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas L. Sitzer, D.d.s., P.a. 2112 Viking Dr Nw Valhalla Dental Building Rochester MN 55901-3522 Ph: (507) 288-0102 | Thomas L. Sitzer, D.d.s., P.a. 2112 Viking Dr Nw Valhalla Dental Building Rochester MN 55901-3522 Ph: (507) 288-0102 |
| NPI Number | 1720369812 |
|---|---|
| Provider Enumeration Date | 09/01/2011 |
| Last Update Date | 09/01/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720369812 | NPI | - | NPPES |
| 779815600 | Medicaid | MN | |
| 39677SI | Other | MN | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 7249 (Minnesota) | Primary |
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