Provider Demographics
NPI:1306363023
Name:FLOEDER, VINCENT IGNATIUS (DDS)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:IGNATIUS
Last Name:FLOEDER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S 1ST ST UNIT 1621
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55401-2571
Mailing Address - Country:US
Mailing Address - Phone:651-600-5493
Mailing Address - Fax:
Practice Address - Street 1:1949 ADMIRAL TAUSSIG BLVD S
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23511-3425
Practice Address - Country:US
Practice Address - Phone:757-953-8635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-23
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FMD13838122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist