National Provider Identifier Database

LAND OF LAKES ENDODONTICS PA
Endodontics

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.


Contact Information

LAND OF LAKES ENDODONTICS PA
2850 CURVE CREST BLVD W STE 115
STILLWATER, MN55082-6101
Phone: 651-439-8764
Fax: 651-439-9660
Website:
Specialty Taxonomy Code
* Endodontics 1223E0200X

* Indicates primary specialty

NPI Profile & details for LAND OF LAKES ENDODONTICS PA

NPI Number 1710108022
Legal business name
LBN
LAND OF LAKES ENDODONTICS PA
Authorized official MATTHEW GRAU - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 05/02/2007
Last updated 02/16/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers
  • MN License #: 11312
  • MN Other: 237L1LA BCBS

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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