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Contact Information

GREAT RIVER ENDODONTICS
9381 CEDAR ST.
MONTICELLO, MN55362
 Phone: 763-295-2222
 Fax: 763-295-2249
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for GREAT RIVER ENDODONTICS · (Female)

NPI # 1275034886
Status Active
Credentials
Entity Individual
Enumeration date 02/28/2018
Last updated 02/28/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • MN License # 11880
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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