MEDICARE: DR. MICHAEL EDWARD FORBES DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	10219	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	008679	OTHER	MN	DORAL DENTAL
2	019ROFO	OTHER	MN	BLUE CROSS BLUE SHIELD
3	1765	OTHER	MN	HEALTH PARTNERS

General Provider Information

NPI Number	:	1013908581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL EDWARD FORBES DDS

Provider Business Mailing Address
First Line	:	4001 STINSON BLVD
Second Line	:	SUITE 426
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55421-3488
Country	:	US
Telephone Number	:	612-788-0751
Fax Number	:	612-788-1014

Provider Business Practice Location Address
First Line	:	4001 STINSON BLVD
Second Line	:	SUITE 426
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55421-3488
Country	:	US
Telephone Number	:	612-788-0751
Fax Number	:	612-788-1014

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	07/08/2007

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