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GREAT LAKES CHILDRENS DENTAL CARE PA NPI 1790795821


NPI Information

NPI: 1790795821
Provider Name: GREAT LAKES CHILDRENS DENTAL CARE PA
Classification: Dentist - 1223D0001X
Entity Type: Organization

Specialization: Dental Public Health

Address:
2710 PIEDMONT AVENUE
DULUTH, MN
ZIP 55811
Phone: (218) 525-5100
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GREAT LAKES CHILDRENS DENTAL CARE PA is a dental public health dentist in Duluth, MN. The provider is the science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis. GREAT LAKES CHILDRENS DENTAL CARE PA NPI is 1790795821. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2710 PIEDMONT AVENUE
DULUTH, MN
ZIP 55811
Phone: (218) 525-5100
Fax: (218) 722-3883

The provider's authorized official is Rami M Guirguis .
The authorized official title is Owner and has the following contact phone number (218) 525-5100.

The enumeration date for this NPI number is 8/9/2006 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223D0001XDentistDental Public HealthD11559MINNESOTAYes
21223P0221XDentistPediatric DentistryD10919MINNESOTAX

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: 4/28/2024

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