Individual provider · Type 1 NPI

Breynne Stacey Fordahl, DDS

General Practice Dentistry · Stillwater, MN

NPI number 1790795235 Active

Practice location

14727 60th St. N
Stillwater, MN 55082

Call (651) 439-9060 Map

Fax (651) 379-9893

Specialties and licenses

TaxonomyCodeLicense
Dentist 122300000X12259 (MN)
General Practice Dentistry Primary 1223G0001XD12259 (MN)

General Practice Dentistry: 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.

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About NPI 1790795235

Breynne Stacey Fordahl, DDS's National Provider Identifier is 1790795235, issued on Aug 8, 2006. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Stillwater, MN. The record was last updated on Nov 30, 2012.