NPI 1033109061

Robert Luther Bodin

Practitioner General Practice Dentistry Edina, MN

Practice location

Address: 5100 Eden Ave, Edina, MN 55436-2337
Phone: (952) 929-0641
Mailing address: 6600 France Ave S, Edina, MN 55435-1805

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence D7172 (MN)

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Registry record

NPI: 1033109061
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Oct 2005
Record last updated: 14 Dec 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.