Provider Demographics
NPI:1396883146
Name:TWOMEY, JONATHAN OLIVER (DDS)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:OLIVER
Last Name:TWOMEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6600 FRANCE AVE S STE 475
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-1804
Mailing Address - Country:US
Mailing Address - Phone:952-920-5300
Mailing Address - Fax:952-920-3799
Practice Address - Street 1:6600 FRANCE AVE S STE 475
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-1804
Practice Address - Country:US
Practice Address - Phone:952-920-5300
Practice Address - Fax:952-920-3799
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND112351223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics