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Contact Information

F C REQUA DDS PA
400 3RD AVE NW
AUSTIN, MN55912
 Phone: 507-433-1641
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for F C REQUA DDS PA

NPI # 1407930415
LBN Legal business name F C REQUA DDS PA
Authorized official FREDERICK REQUA - (PRES)
Entity Organization
Organization subpart 1 No
Enumeration date 10/25/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
MN License # 6155
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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