Individual
DR. HARISH KORATKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BDS, MS
Contact information
Practice address
2500 COMO AVE, HEALTHPARTNERS COMO DENTAL SPECIALTY CLINIC, SAINT PAUL, MN 55108-1460
(925) 489-9009
Mailing address
2500 COMO AVE, HEALTHPARTNERS COMO DENTAL SPECIALTY CLINIC, SAINT PAUL, MN 55108-1460
(651) 647-2500
(651) 632-8984
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
60400
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
263626300
MN HEALTH CARE PROGRAM
MN
01
—
74G72KO
BLUE CROSS BLUE SHIELD
MN
Enumeration date
03/30/2007
Last updated
10/15/2014
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