Provider Demographics
NPI:1730255373
Name:CENTERPOINTE DENTAL GROUP PA
Entity type:Organization
Organization Name:CENTERPOINTE DENTAL GROUP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:EMERY
Authorized Official - Last Name:KRECH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:952-892-3808
Mailing Address - Street 1:14321 NICOLLET COURT
Mailing Address - Street 2:SUITE #200
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306
Mailing Address - Country:US
Mailing Address - Phone:952-892-3808
Mailing Address - Fax:952-892-7727
Practice Address - Street 1:14321 NICOLLET COURT
Practice Address - Street 2:SUITE #200
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306
Practice Address - Country:US
Practice Address - Phone:952-892-3808
Practice Address - Fax:952-892-7727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty