MEDICARE: DR. DAVID A. UPPGAARD 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	1223G0001X	General Practice Dentistry	9817	MN

General Provider Information

NPI Number	:	1073568267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID A. UPPGAARD DDS

Provider Business Mailing Address
First Line	:	825 NICOLLET MALL
Second Line	:	SUITE 1737
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55402-2606
Country	:	US
Telephone Number	:	612-332-1164
Fax Number	:

Provider Business Practice Location Address
First Line	:	825 NICOLLET MALL
Second Line	:	SUITE 1737
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55402-2606
Country	:	US
Telephone Number	:	612-332-1164
Fax Number	:

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	07/08/2007

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