Organization Name: | CENTRAL MN PEDIATRIC DENTISTS, PA |
NPI Number: | 1174962674 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL W. STEIL (PARTNER/OWNER) |
Mailing Address: | 1903 S 6th St Brainerd |
State: | MN US |
Postal Code: | 564014599 |
Phone Number: | 3202530272 |
Fax Number: | 3202512661 |
NPI Enumeration Date: | 06/18/2013 |
NPI Last Update Date: | 06/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | D7765 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |