| Lee Prohofsky Dds Pa | |
|
14000 Northdale Blvd Ste J Rogers MN 55374-4663 | |
| (763) 428-2300 | |
| (763) 428-4031 |
| Full Name | Lee Prohofsky Dds Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 14000 Northdale Blvd Ste J, Rogers, Minnesota |
| Authorized Official Name and Position | Lee Steven Prohofsky (PRESIDENT,OWNER) |
| Authorized Official Contact | 7634282300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lee Prohofsky Dds Pa 14000 Northdale Blvd Ste J Rogers MN 55374-4663 Ph: (763) 428-2300 | Lee Prohofsky Dds Pa 14000 Northdale Blvd Ste J Rogers MN 55374-4663 Ph: (763) 428-2300 |
| NPI Number | 1215097134 |
|---|---|
| Provider Enumeration Date | 12/11/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215097134 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 10843 (Minnesota) | Primary |
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