Mary Elizabeth Imdieke
Prosthodontist
515 Delaware St Se Cleft Palate Clinic - 6th Floor Moos Tower
Minneapolis
, Minnesota 55455-0357
Mary Elizabeth Imdieke
Prosthodontist
515 Delaware St Se Cleft Palate Clinic - 6th Floor Moos Tower
Minneapolis
, Minnesota 55455-0357
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About
Features
Specialties
- Prosthodontist
Languages spoken
- English
Location
First Address
- Mary Elizabeth Imdieke
- 515 Delaware St Se Cleft Palate Clinic - 6th Floor Moos Tower
- Minneapolis, MN
- Zip : 55455-0357
- Phone :
Second Address
- Mary Elizabeth Imdieke
- 515 Delaware St Se Cleft Palate Clinic - 6th Floor Moos Tower
- Minneapolis, MN
- Zip : 55455-0357
- Phone : (612) 625-2495
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0700X | Prosthodontist | D11276 | MN |
National Provider Identifier
| NPI | 1023180023 |
|---|---|
| Provider Name | Mary Elizabeth Imdieke |
| First Address | Minneapolis, MN 55455-0357 |
| Second Address | Minneapolis, MN 55455-0357 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/11/2006 |
| Last Update Date | 14/08/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| U50893 | (02) | MN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.