Roseville Dentistry

NPI #1417191602 in Roseville, Minnesota

Provider Information

NPI Number: 1417191602
Entity Type: Organization
Organization Name: Roseville Dentistry
Primary Specialty: Dentist - General Practice
Enumeration Date: May 1, 2009
Last Updated: May 1, 2009

Practice Location

Address: 1912 LEXINGTON AVE N
Address 2: SUITE 200
City: Roseville
State: Minnesota
ZIP Code: 55113-6113
Phone: (651) 631-3610

Authorized Official

Name: HEIDI JO DULIN, RDA
Title: OFFICE MANAGER
Phone: (651) 631-3610

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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