Great Lakes Childrens Dental Care Pa in Duluth - Pediatric Dentistry
Great Lakes Childrens Dental Care Pa - NPI 1790795821
Great Lakes Childrens Dental Care Pa is a Pediatric Dentistry in Duluth, Minnesota. Great Lakes Childrens Dental Care Pa practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Great Lakes Childrens Dental Care Pa is 1790795821. The last update date is 2020-08-22.
Great Lakes Childrens Dental Care Pa's current location address is 2710 Piedmont Avenue, Duluth, Minnesota. You can contact this provider via phone number 2185255100 and fax number 2187223883. The mailing address for Great Lakes Childrens Dental Care Pa is 2710 Piedmont Avenue, Duluth, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Great Lakes Childrens Dental Care Pa |
|---|---|
| Address | 2710 Piedmont Avenue, Duluth, Minnesota |
| Phone Number | 2185255100 |
| Fax Number | 2187223883 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Guirguis M Rami |
| Credentials | DDS MS |
| Telephone Number | 2185255100 |
NPI Number Detail
| NPI Number | 1790795821 |
|---|---|
| Provider Enumeration Date | 2006-08-09 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 2710 Piedmont Avenue |
|---|---|
| City | Duluth |
| State | Minnesota (MN) |
| Post Code | 55811 |
| Phone Number | 2185255100 |
| Fax Number | 2187223883 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | D10919 |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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What is the unique 10-digit identifier code assigned to Great Lakes Childrens Dental Care Pa by the Centers for Medicare & Medicaid Services?
The Great Lakes Childrens Dental Care Pa has been issued the NPI (National Provider Identifier) 1790795821 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Great Lakes Childrens Dental Care Pa located?
The Great Lakes Childrens Dental Care Pa is located at 2710 Piedmont Avenue, Duluth, MN 55811.
What is the Great Lakes Childrens Dental Care Pa's specialty and taxonomy code?
The Great Lakes Childrens Dental Care Pa's specialty is Pediatric Dentistry, and the corresponding taxonomy code is 1223P0221X.
On what date did the Great Lakes Childrens Dental Care Pa receive the assignment of its 1790795821 from the Centers for Medicare & Medicaid Services?
The Great Lakes Childrens Dental Care Pa was issued its 1790795821 by the Centers for Medicare & Medicaid Services on 2006-08-09.
As of what date were the details pertaining to Great Lakes Childrens Dental Care Pa last refreshed?
The information related to the Great Lakes Childrens Dental Care Pa, including its address, specialty, and other relevant details, was last updated on 2020-08-22.