Healthcare Provider Details

I. General information

NPI: 1669461554
Provider Name (Legal Business Name): JAMES BARTHEL D.D.S.,M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 11/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 HIGHWAY 55 STE 202
HASTINGS MN
55033-3734
US

IV. Provider business mailing address

925 HIGHWAY 55 STE 202
HASTINGS MN
55033-3734
US

V. Phone/Fax

Practice location:
  • Phone: 651-437-3262
  • Fax: 651-437-7684
Mailing address:
  • Phone: 651-437-3262
  • Fax: 651-437-7684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License NumberD7655
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: