DISTINCTIVE DENTAL SERVICES PA NPI 1073780805

NPI Information

  • NPI: 1073780805
  • Provider Name: DISTINCTIVE DENTAL SERVICES, PA
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Doing Business As: HOWARD LAKE DENTAL
  • Address: 612 8TH AVE # 664
    HOWARD LAKE, MN
    ZIP 55349
  • Phone: (320) 543-2233

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NPI Details

DISTINCTIVE DENTAL SERVICES, PA is a general practice dentist in Howard Lake, 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. DISTINCTIVE DENTAL SERVICES, PA NPI is 1073780805. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Howard Lake Dental.

The provider's business location address is:

612 8TH AVE # 664
HOWARD LAKE, MN
ZIP 55349-137
Phone: (320) 543-2233
Fax: (320) 543-2368

The provider's authorized official is Michael John Thoennes .
The authorized official title is Ceo and has the following contact phone number (320) 485-4344.

The enumeration date for this NPI number is 5/12/2008 and was last updated on 5/12/2008.

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 PracticeD08971MINNESOTAYes

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: 11/21/2025

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