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ANDOVER FAMILY DENTISTRY LLC NPI 1730256132


NPI Information

NPI: 1730256132
Provider Name: ANDOVER FAMILY DENTISTRY, LLC

Doing Business As: ANDOVER FAMILY DENTISTRY

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
3480 BUNKER LAKE BLVD NW
SUITE 202
ANDOVER, MN
ZIP 55304
Phone: (763) 427-4780
Get Directions

ANDOVER FAMILY DENTISTRY, LLC is a general practice dentist in Andover, MN. The provider is 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. ANDOVER FAMILY DENTISTRY, LLC NPI is 1730256132. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Andover Family Dentistry.

The provider's business location address is:

3480 BUNKER LAKE BLVD NW
SUITE 202
ANDOVER, MN
ZIP 55304
Phone: (763) 427-4780
Fax: (763) 427-8471

The provider's authorized official is Ethan R Chute .
The authorized official title is President and has the following contact phone number (763) 427-4780.

The enumeration date for this NPI number is 11/29/2006 and was last updated on 6/19/2019.


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
11223G0001XDentistGeneral PracticeD11439MINNESOTANo
21223G0001XDentistGeneral PracticeYes

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

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