MEDICARE: DR. DENNIS JAMES GRABOWSKI 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
1	1223G0001X	General Practice Dentistry	D7732	MN

General Provider Information

NPI Number	:	1073613642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS JAMES GRABOWSKI DDS

Provider Business Mailing Address
First Line	:	8981 HIGHWAY 5
Second Line	:
City	:	LAKE ELMO
State	:	MN
Zip	:	55042-8900
Country	:	US
Telephone Number	:	651-777-1337
Fax Number	:	651-748-0480

Provider Business Practice Location Address
First Line	:	8981 HIGHWAY 5
Second Line	:
City	:	LAKE ELMO
State	:	MN
Zip	:	55042-8900
Country	:	US
Telephone Number	:	651-777-1337
Fax Number	:	651-748-0480

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	07/08/2007

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