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Contact Information

NORTHLAND ENDODONTICS PA
11800 ABERDEEN ST NE
SUITE 140
BLAINE, MN55449-4808
 Phone: 763-772-0330
 Fax: 763-772-0354
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for NORTHLAND ENDODONTICS PA

NPI # 1932200037
LBN Legal business name NORTHLAND ENDODONTICS PA
Authorized official KRIS JOHNSON - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/25/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
MN License # D10585
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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