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NPI Code Detail

MEDICARE: METROPOLITAN ENDODONTICS, LTD.

MEDICARE: METROPOLITAN ENDODONTICS, LTD.
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
11223E0200XEndodontics

General Provider Information

NPI Number : 1477634343
Entity Type Code : Organization
Provider Name (Legal Business Name) : METROPOLITAN ENDODONTICS, LTD.
Provider Business Mailing Address
First Line : 2125 UPPER 55TH ST E
Second Line :
City : INVER GROVE HEIGHTS
State : MN
Zip : 55077-1734
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2125 UPPER 55TH ST E
Second Line :
City : INVER GROVE HEIGHTS
State : MN
Zip : 55077-1734
Country : US
Telephone Number : 952-435-0370
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. ERIC HOLMES GRUTZNER
Credential : D.D.S., M.S.
Telephone Number : 651-451-6479
Provider Enumeration Date : 10/18/2006
Last Update Date : 03/20/2013

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