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Contact Information

MADELEINNE FERN
7770 DELL ROAD, SUITE #110
CHANHASSEN, MN55317-2809
 Phone: 952-294-3575
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for MADELEINNE FERN · (Female)

NPI # 1124896816
Status Active
Credentials
Entity Individual
Enumeration date 12/13/2023
Last updated 08/14/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • MN License # D15023
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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