MR. MARK W BOBACK (NPI# 1700997327) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700997327 |
| Entity Type | Individual |
| Full Name | MR. MARK W BOBACK |
| Credential | DDS |
| Practice Address |
22 W 3rd Ave N Aurora MN 55705 |
| Mailing Address |
27 N Erie St Aurora MN 55705 |
| Practice Telephone | 2182293341 |
| Mailing Telephone | 2182292112 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 7982 | MN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MNCARE # | 6175382 | 01 |
| Street Address |
22 W 3RD AVE N |
| City | AURORA |
| State | MN |
| Zip Code | 55705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144436189 | Mary Agnes Johnson | Technician | 705 Knuti Dr, Aurora, MN 55705 | 2007-05-15 |
| 1871651646 | Northern Pines Medical Center | Pharmacy | 5211 Hwy 110, Aurora, MN 55705 | 2006-12-05 |
| 1346252053 | Claude Erickson | Physician Assistant | 405 West 3rd Ave N, Aurora, MN 55705 | 2006-08-12 |
| 1780838151 | Vision Pro | Optometrist | 5211 Hwy 110, White Community Hospital, Aurora, MN 55705 | 2008-11-11 |
| 1265533400 | Ericka Janette Lamar | Psychologist | 5211 Highway 110, Essentia Health Northern Pines Clinic, Aurora, MN 55705 | 2006-09-26 |
| 1982641791 | The Duluth Clinic, Ltd | Clinic/Center | 405 W 3rd Ave N, Box 392, Aurora, MN 55705-1247 | 2006-06-01 |
| 1447817978 | Mesabacare LLC | Counselor | 405 W 3rd Ave N, Aurora, MN 55705-1247 | 2019-05-21 |
| 1063704930 | Ann Marie Westbrook Vreeland | Nurse Practitioner | 405 W 3rd Ave N, Aurora, MN 55705-1247 | 2011-05-10 |
| 1811920564 | Michelle Renee Oman | Family Medicine | 405 W 3rd Ave N, Aurora, MN 55705-1247 | 2006-07-08 |
| 1457958498 | Carol Ruth Haasl | Community Health Worker | 215 W 4th Ave N, Aurora, MN 55705-1252 | 2020-10-02 |
| Find all providers in zip 55705 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669086252 | Chancy Hanquist | Dentist | 1830 E Condon Ave, Aurora, NE 68818-3135 | 2020-09-02 |
| 1376169714 | Puneet Kaur Pandher | Dentist | 13650 E Colfax Ave Apt 3115, Aurora, CO 80011-6989 | 2020-06-22 |
| 1043835648 | Kelli Williams | Dentist | 3162 S Hannibal St, Aurora, CO 80013-1750 | 2020-06-10 |
| 1588288062 | Lynn Doan | Dentist | 12357 E Cornell Ave Unit 10, Aurora, CO 80014-3323 | 2020-06-01 |
| 1447895255 | Aurora Dentist Office and Orthodontics, LLP | Dentist | 12101 E Dartmouth Ave Ste 200, Aurora, CO 80014-4948 | 2019-11-15 |
| 1942843420 | Palak M Shah | Dentist | 1261 N Lake St Ste J, Aurora, IL 60506-2471 | 2019-10-28 |
| 1811547631 | Aurora Dental and Orthodontics Pllc | Dentist | 15000 E Mississippi Ave, Aurora, CO 80012 | 2019-09-13 |
| 1518515162 | Manju Suresh | Dentist | 1264a N Lake St, Aurora, IL 60506-2453 | 2019-08-27 |
| 1346801958 | Gabrielle Brandt | Dentist | 25791 E Smoky Hill Rd Unit 10, Aurora, CO 80016-1793 | 2019-06-25 |
| 1649831546 | Kevin Smith | Dentist | 5657 S Himalaya St Ste 270, Aurora, CO 80015-5310 | 2019-06-22 |
| Find all providers in AURORA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.