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NPI Code Detail

MEDICARE: DR. CHARLES FRANCIS KAMINSKI JR. DDS

MEDICARE: DR. CHARLES FRANCIS KAMINSKI JR. DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry8711MN

General Provider Information

NPI Number : 1073525184
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES FRANCIS KAMINSKI JR. DDS
Provider Business Mailing Address
First Line : 4754 WASHINGTON SQUARE
Second Line :
City : WHITE BEAR LAKE
State : MN
Zip : 55110-3257
Country : US
Telephone Number : 651-426-9499
Fax Number : 651-429-6255
Provider Business Practice Location Address
First Line : 4754 WASHINGTON SQUARE
Second Line :
City : WHITE BEAR LAKE
State : MN
Zip : 55110-3257
Country : US
Telephone Number : 651-426-9499
Fax Number : 651-429-6255
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2006
Last Update Date : 07/08/2007

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