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Mrs. Madison Rae Dickovich, DMD
Student in an Organized Health Care Education/Training Program in Rochester, Minnesota
NPI 1952985574

Madison Rae Dickovich is a Student in an Organized Health Care Education/Training Program based in Shakopee, MN. Madison Rae Dickovich practices in Rochester, MN and has the professional credentials of DMD. The NPI Number for Madison Rae Dickovich is 1952985574 and holds a License No. D14584 (Minnesota).

The current practice location address for Madison Rae Dickovich is 2056 Superior Dr Nw, Rochester, MN and can be reached out via phone at 507-315-4015.

Location: 2056 Superior Dr Nw, Rochester, MN, 55379-9476
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1952985574
Provider Name
Madison Rae Dickovich
Credential
DMD
Provider Entity Type
Individual
Gender
Female
Address
2056 Superior Dr Nw, Rochester, MN, 55379-9476
Phone Number
507-315-4015
Fax Number
Provider Enumeration Date
05/10/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2056 Superior Dr Nw
City
Rochester
State
Minnesota
Zip
55901-5024
Phone Number
507-315-4015
Fax Number
person
Provider Business Mailing Address Details
Address
2056 Superior Dr Nw
City
Rochester
State
Minnesota
Zip
55901-5024
Phone Number
507-315-4015
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
()
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
D14584 (Minnesota)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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