Healthcare Provider Details
I. General information
NPI: 1275292641
Provider Name (Legal Business Name): KUHR DENTAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/14/2021
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
205 LEWIS ST S STE 101
SHAKOPEE MN
55379-2290
US
IV. Provider business mailing address
20265 VERNON AVE
PRIOR LAKE MN
55372-8122
US
V. Phone/Fax
- Phone: 952-445-3349
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BENJAMIN
ROBERT
KUHR
Title or Position: DENTIST
Credential: DDS
Phone: 612-810-6638