Okoruwa, Ebosetale Odiaogbe

Okoruwa, Ebosetale Odiaogbe is an individual health care provider with primary practice located at 6936 Pine Arbor Dr S Ste 230 , Cottage Grove MN 55016-4645. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Student, Health Care / Student in an Organized Health Care Education/Training Program. Dental Providers / Dentist is his primary health care specialty. Okoruwa, Ebosetale Odiaogbe can be contacted via phone (651) 204-5257.

Contact Information

Primary practice address
6936 Pine Arbor Dr S Ste 230 Cottage Grove MN 55016-4645
Phone: (651) 204-5257
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 1002470 Wisconsin
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dental Providers / Dentist 122300000X D14478 Minnesota

Profile Details

NPI number 1417444332
LBN Legal business name Okoruwa, Ebosetale Odiaogbe
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 16th, 2018
Last updated Feb 12th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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