Healthcare Provider Details

I. General information

NPI: 1477963288
Provider Name (Legal Business Name): ALLAN RAU D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2014
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2251 CONNECTICUT AVE S
SARTELL MN
56377-2486
US

IV. Provider business mailing address

2251 CONNECTICUT AVE S
SARTELL MN
56377-2486
US

V. Phone/Fax

Practice location:
  • Phone: 320-253-5220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberD13387
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD13387
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: