Provider Demographics
NPI:1972616902
Name:RENSCH, BECKER AND IWEN, D.D.S., P.A.
Entity Type:Organization
Organization Name:RENSCH, BECKER AND IWEN, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:E
Authorized Official - Last Name:RENSCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:763-427-1363
Mailing Address - Street 1:402 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-2516
Mailing Address - Country:US
Mailing Address - Phone:763-427-2740
Mailing Address - Fax:763-427-1363
Practice Address - Street 1:402 MONROE ST
Practice Address - Street 2:
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-2516
Practice Address - Country:US
Practice Address - Phone:763-427-2740
Practice Address - Fax:763-427-1363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty