A Gentle Dental Center of Rogers

Organization Active NPI General Practice Dentistry · Rogers, MN

NPI 1124198635 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1124198635
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
D11666 (MN)
Legal business name
A GENTLE DENTAL CENTER OF ROGERS
Practice address
14115 James Rd
Suite 303
Rogers, MN 55374-9468
Phone
(763) 428-2226
Fax
(763) 428-3407
NPI assigned
Nov 9, 2006
Organization subpart
No

Authorized official

Name
Dr. Jill Pucel Koopman, D.D.S.
Title
Owner
Phone
(763) 428-2226

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

14115 James Rd
Ste 303
Rogers, MN 55374
Phone (763) 428-2226

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X D11666 MN Yes

Addresses

Primary practice location

14115 James Rd
Suite 303
Rogers, MN 55374-9468

Mailing address

14115 James Rd
Suite 303
Rogers, MN 55374-9468
Phone (763) 428-2226

Other providers in Rogers, MN

All providers in Rogers, MN · General Practice Dentistry in Minnesota

Sources for this page

Verify at the official NPI Registry.