Provider Demographics
NPI:1255494712
Name:OXBORO DENTAL CARE
Entity Type:Organization
Organization Name:OXBORO DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:W
Authorized Official - Last Name:SWENBY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:952-881-2243
Mailing Address - Street 1:525 W 98TH ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55420-4713
Mailing Address - Country:US
Mailing Address - Phone:952-881-2243
Mailing Address - Fax:952-888-6988
Practice Address - Street 1:525 W 98TH ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55420-4713
Practice Address - Country:US
Practice Address - Phone:952-881-2243
Practice Address - Fax:952-888-6988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN105401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty