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Contact Information

WAYZATA ENDODONTICS PA
250 N CENTRAL AVE
SUITE 303
WAYZATA, MN55391
 Phone: 952-476-0070
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for WAYZATA ENDODONTICS PA

NPI # 1508926841
LBN Legal business name WAYZATA ENDODONTICS PA
Authorized official GREGORY OTOOLE - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/09/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
MN License # 11543
MN License # 9011
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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