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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

NPI Number 1275034886
LBN Legal business name GREAT RIVER ENDODONTICS
Authorized official THOMAS KARN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 02/28/2018
Last updated 02/28/2018 - About 8 years ago
Identifiers
MN License # 11880
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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