Provider Demographics
NPI:1790723302
Name:AAMODT, JOHN CHRISTOPHER (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHRISTOPHER
Last Name:AAMODT
Suffix:
Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:1329 FAIRMOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-2704
Mailing Address - Country:US
Mailing Address - Phone:651-695-9574
Mailing Address - Fax:
Practice Address - Street 1:2130 CLIFF RD
Practice Address - Street 2:SUITE 220
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-2485
Practice Address - Country:US
Practice Address - Phone:651-405-1055
Practice Address - Fax:651-405-0727
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MND113341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics