Healthcare Provider Details

I. General information

NPI: 1568189520
Provider Name (Legal Business Name): JOHN F. ENGLUND DDS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2022
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CENTRAL AVE
OSSEO MN
55369
US

IV. Provider business mailing address

100 CENTRAL AVE
OSSEO MN
55369
US

V. Phone/Fax

Practice location:
  • Phone: 763-425-8200
  • Fax: 763-425-0946
Mailing address:
  • Phone: 763-425-8200
  • Fax: 763-425-0946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN FREDERICK ENGLUND
Title or Position: PRESIDENT
Credential: DDS
Phone: 763-425-8200