MEDICARE: RACHEL K. GRIEGER DDS PA

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

General Provider Information

NPI Number	:	1477968238
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RACHEL K. GRIEGER DDS PA

Provider Business Mailing Address
First Line	:	206 WALKER AVE N
Second Line	:
City	:	NEW YORK MILLS
State	:	MN
Zip	:	56567-4004
Country	:	US
Telephone Number	:	218-385-3130
Fax Number	:	218-385-9131

Provider Business Practice Location Address
First Line	:	206 WALKER AVE N
Second Line	:
City	:	NEW YORK MILLS
State	:	MN
Zip	:	56567-4004
Country	:	US
Telephone Number	:	218-385-3130
Fax Number	:	218-385-9131

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	DR. RACHEL KREKULA GRIEGER
Credential	:	DDS
Telephone Number	:	218-385-3130

Provider Enumeration Date	:	06/30/2014
Last Update Date	:	06/30/2014

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