| NPI | 1053834481 |
|---|---|
| Former Legal Business Name | ROGER MONDALE DDS |
| Doing Business As | ROGER MONDALE, DDS |
| Entity Type | Organization |
| Authorized Contact | BRIAN PATRICK MONDALE Owner Sole Member 763-512-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2024-07-30 |