Vansurksum, Roderick Duane

Vansurksum, Roderick Duane is an individual health care provider with primary practice located at 11601 Minnetonka Mills Rd Ste F40 , Minnetonka MN 55305-5189. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Vansurksum, Roderick Duane can be contacted via phone (952) 935-8420.

Contact Information

Primary practice address
11601 Minnetonka Mills Rd Ste F40 Minnetonka MN 55305-5189
Phone: (952) 935-8420
Fax: (952) 935-0147
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X D11417 Minnesota

Profile Details

NPI number 1699964320
LBN Legal business name Vansurksum, Roderick Duane
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2007
Last updated Jun 16th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699964320 NPPES
Minnesota MEDICAID 704432100

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