Provider Demographics
NPI:1114981677
Name:PATTI FROEBER COMPREHENSIVE DENTISTRY PA
Entity Type:Organization
Organization Name:PATTI FROEBER COMPREHENSIVE DENTISTRY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FROEBER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:612-379-2428
Mailing Address - Street 1:312 CENTRAL AVE SE
Mailing Address - Street 2:SUITE 440
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414
Mailing Address - Country:US
Mailing Address - Phone:612-379-2428
Mailing Address - Fax:612-379-0538
Practice Address - Street 1:312 CENTRAL AVE SE
Practice Address - Street 2:SUITE 440
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414
Practice Address - Country:US
Practice Address - Phone:612-379-2428
Practice Address - Fax:612-379-0538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-13
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN102721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty