12Th Street Dental Office Pa in Rochester - Dentist
12Th Street Dental Office Pa - NPI 1043374176
12Th Street Dental Office Pa is a Dentist in Rochester, Minnesota. 12Th Street Dental Office Pa practices all healthcare services and medical treatments related to Dentist. The NPI Number for 12Th Street Dental Office Pa is 1043374176. The last update date is 2020-08-22.
12Th Street Dental Office Pa's current location address is 1008 12th Street Se, Rochester, Minnesota. You can contact this provider via phone number 5072826448 and fax number 5072878846. The mailing address for 12Th Street Dental Office Pa is 1008 12th Street Se, Rochester, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | 12Th Street Dental Office Pa |
|---|---|
| Address | 1008 12th Street Se, Rochester, Minnesota |
| Phone Number | 5072826448 |
| Fax Number | 5072878846 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER PART |
|---|---|
| Authorized Official Name | Becker Gerard Joseph |
| Credentials | DDS |
| Telephone Number | 5072826448 |
NPI Number Detail
| NPI Number | 1043374176 |
|---|---|
| Provider Enumeration Date | 2006-12-21 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 1008 12th Street Se |
|---|---|
| City | Rochester |
| State | Minnesota (MN) |
| Post Code | 559045030 |
| Phone Number | 5072826448 |
| Fax Number | 5072878846 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | MN9567 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the unique 10-digit identification code assigned to 12Th Street Dental Office Pa by the Centers for Medicare & Medicaid Services?
The 12Th Street Dental Office Pa has been issued the NPI (National Provider Identifier) 1043374176, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of 12Th Street Dental Office Pa?
The 12Th Street Dental Office Pa is physically situated at 1008 12Th Street Se, in the city of Rochester, state of MN, with the postal code 559045030.
What is 12Th Street Dental Office Pa's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The 12Th Street Dental Office Pa's specialized field of practice is Dentist, and the corresponding taxonomy code that categorizes this area of specialization is 122300000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1043374176 to 12Th Street Dental Office Pa?
The Centers for Medicare & Medicaid Services originally issued the 1043374176 to 12Th Street Dental Office Pa on 2006-12-21.
As of what date were the details related to 12Th Street Dental Office Pa most recently updated or revised?
The information pertaining to 12Th Street Dental Office Pa, including its address, specialty, and other relevant details, was last updated or revised on 2020-08-22.
NPI Number: 1952305922
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