| Bruce K.a. Dormanen, P.a. | |
|
2150 3rd Ave Ste 200 Anoka MN 55303-2200 | |
| (763) 421-9292 | |
| (763) 421-7559 |
| Full Name | Bruce K.a. Dormanen, P.a. |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 2150 3rd Ave Ste 200, Anoka, Minnesota |
| Authorized Official Name and Position | Bruce K.a. Dormanen (CEO) |
| Authorized Official Contact | 7634219292 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bruce K.a. Dormanen, P.a. 2150 3rd Ave Ste 200 Anoka MN 55303-2200 Ph: (763) 421-9292 | Bruce K.a. Dormanen, P.a. 2150 3rd Ave Ste 200 Anoka MN 55303-2200 Ph: (763) 421-9292 |
| NPI Number | 1316035595 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316035595 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 8151 (Minnesota) | Primary |
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