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General NPI Number Information
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NPI Number | 1821201401
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Entity Type | Organization
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Legal Business Name | CENTERPOINTE DENTAL
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 209 E MAIN ST
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City | OWATONNA
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State | MN
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Zip | 55060-3075
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Country | US
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Telephone | 507-455-1641
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Fax |
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Provider Business Mailing Address
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Address Line | 209 E MAIN ST
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City | OWATONNA
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State | MN
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Zip | 55060-3075
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Country | US
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Telephone | 507-455-1641
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | THOMAS SMITH
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Credential | DDS
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Telephone | 507-455-1641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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