MEDICARE: THE NEW ART OF DENTISTRY

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51575MI	OTHER	MN	BLUE CROS BLUE SHIELD

General Provider Information

NPI Number	:	1548487689
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE NEW ART OF DENTISTRY

Provider Business Mailing Address
First Line	:	1222 N FRONTAGE RD
Second Line	:
City	:	HASTINGS
State	:	MN
Zip	:	55033-2359
Country	:	US
Telephone Number	:	651-437-1166
Fax Number	:	651-437-6488

Provider Business Practice Location Address
First Line	:	1222 N FRONTAGE RD
Second Line	:
City	:	HASTINGS
State	:	MN
Zip	:	55033-2359
Country	:	US
Telephone Number	:	651-437-1166
Fax Number	:	651-437-6488

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EDWARD DEUTSCHMANN
Credential	:
Telephone Number	:	651-437-1166

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	08/22/2020

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Directions to “THE NEW ART OF DENTISTRY ” Practice Location

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