SAINT ANTHONY VILLAGE DENTISTRY NPI 1528535788

NPI Information

NPI: 1528535788
Provider Name: SAINT ANTHONY VILLAGE DENTISTRY
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
2525 33RD AVE NE
ST ANTHONY, MN
ZIP 55418
Phone: (612) 781-9270
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SAINT ANTHONY VILLAGE DENTISTRY is a dental clinic center in St Anthony, MN. SAINT ANTHONY VILLAGE DENTISTRY NPI is 1528535788. The provider is registered as an organization entity type.

The provider's business location address is:

2525 33RD AVE NE
ST ANTHONY, MN
ZIP 55418-539
Phone: (612) 781-9270
Fax: (612) 767-3490

The provider's authorized official is Cory John Larson .
The authorized official title is Dentist and has the following contact phone number (612) 789-2853.

The enumeration date for this NPI number is 10/25/2018 and was last updated on 10/25/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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