Woodland Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

License

11459 Issued in MN

Legal business name

WOODLAND DENTAL LLC

Practice address

510 1St St
Princeton, MN 55371-1604

Phone

(763) 389-1373

NPI assigned

Sep 23, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Diana Ross Snelgrove

Title

Office Manager

Phone

(218) 631-4431

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1861861619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 1ST ST",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "553711604",
            "telephone_number": "763-389-1373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 1ST ST",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "553711604",
            "telephone_number": "763-389-1373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLAND DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "SNELGROVE",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "ROSS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "218-631-4431"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "11459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jocelyn Wiedewitsch
• Lucas Burton Winskowski, LADC
• Barbara Lynn Wisniewski, LPCC
• Renae Helen Witta, OTR/L
• Amanda Wolfsteller
• Nicole K Wyganowski, RN, PHN, LSN
• Michael A Zurek, MD

• Dentist in Princeton, MN
• Providers in Princeton, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.