Provider Demographics
NPI:1679795983
Name:BREMSETH, NANCY JO (DDS)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:JO
Last Name:BREMSETH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28384 RIDGEVIEW DR S
Mailing Address - Street 2:
Mailing Address - City:RED WING
Mailing Address - State:MN
Mailing Address - Zip Code:55066-6037
Mailing Address - Country:US
Mailing Address - Phone:651-388-9324
Mailing Address - Fax:
Practice Address - Street 1:621 W 4TH ST
Practice Address - Street 2:
Practice Address - City:RED WING
Practice Address - State:MN
Practice Address - Zip Code:55066-2413
Practice Address - Country:US
Practice Address - Phone:651-388-3535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN110911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice