Organization
GREAT RIVER ENDODONTICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS ANDREW KARN DMD (OWNER/PRESIDENT)
(320) 259-5078
Entity
Organization
Contact information
Practice address
1100 19TH AVE SW, WILLMAR, MN 56201-5006
(320) 259-5078
(320) 259-5078
Mailing address
622 ROOSEVELT RD STE 180, SAINT CLOUD, MN 56301-6361
(320) 259-5078
(320) 259-1484
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
11880
MN
Other
Enumeration date
06/20/2012
Last updated
06/20/2012
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