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Contact Information

KELLIE E ROSEBERG, DDS
306 BRIGHTON AVE S
BUFFALO, MN55313
 Phone: 763-682-2572
 Fax: 763-533-2034
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for KELLIE E ROSEBERG · (Female)

NPI # 1265511844
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 11/03/2006
Last updated 06/18/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • MN License # D12121
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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