Provider Demographics
NPI:1154556793
Name:RAMBOW, ERIC J (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:J
Last Name:RAMBOW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:MN
Mailing Address - Zip Code:56267-1212
Mailing Address - Country:US
Mailing Address - Phone:320-589-2161
Mailing Address - Fax:
Practice Address - Street 1:201 E 6TH ST
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:MN
Practice Address - Zip Code:56267-1212
Practice Address - Country:US
Practice Address - Phone:320-589-2161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND126881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice