Provider Demographics
NPI:1659585891
Name:BORAAS, JOANN CHRISTINE (DDS, MS)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:CHRISTINE
Last Name:BORAAS
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6945 PENN AVE S
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-2081
Mailing Address - Country:US
Mailing Address - Phone:612-866-4041
Mailing Address - Fax:612-866-4042
Practice Address - Street 1:6945 PENN AVE S
Practice Address - Street 2:SUITE 102
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2081
Practice Address - Country:US
Practice Address - Phone:612-866-4041
Practice Address - Fax:612-866-4042
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN96541223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry