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Contact Information

PAUL R BENGTSON, DDS
49 SUMMIT AVE E
BLACKDUCK, MN56630
 Phone: 218-835-4227
 Fax: 218-835-7512
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for PAUL R BENGTSON · (Male)

NPI Number 1225203359
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 04/29/2008
Last updated 04/29/2008 - About 18 years ago
Sole proprietor 1 Yes
Identifiers
  • MN License # 7789
  • MN Medicaid 141818100
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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