Imagine Orthodontics

NPI #1417142175 in Rogers, Minnesota

Provider Information

NPI Number: 1417142175
Entity Type: Organization
Organization Name: Imagine Orthodontics
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: Sep 6, 2007
Last Updated: Sep 30, 2009

Practice Location

Address: 14020 NORTHDALE BLVD
City: Rogers
State: Minnesota
ZIP Code: 55374-9612
Phone: (763) 428-1912

Authorized Official

Name: DR. SARAH MARIE SOLTYS LARSON, DDS
Title: PRESIDENT
Phone: (612) 802-4673

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X	Primary

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