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GREAT RIVER ENDODONTICS PA NPI 1861708828


NPI Information

NPI: 1861708828
Provider Name: GREAT RIVER ENDODONTICS, PA
Classification: Dentist - 1223E0200X
Entity Type: Organization

Specialization: Endodontics

Address:
622 ROOSEVELT RD
SUITE 180
SAINT CLOUD, MN
ZIP 56301
Phone: (320) 259-5078
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GREAT RIVER ENDODONTICS, PA is an endodontics dentist in Saint Cloud, MN. The provider is the branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. GREAT RIVER ENDODONTICS, PA NPI is 1861708828. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

622 ROOSEVELT RD
SUITE 180
SAINT CLOUD, MN
ZIP 56301-153
Phone: (320) 259-5078
Fax: (320) 259-1484

The provider's authorized official is Thomas Andrew Karn .
The authorized official title is Owner/president and has the following contact phone number (320) 259-5078.

The enumeration date for this NPI number is 8/27/2010 and was last updated on 8/27/2010.


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
11223E0200XDentistEndodonticsUNKNOWNMINNESOTAYes

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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