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Organization

GREAT RIVER ENDODONTICS, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS ANDREW KARN DMD, MS (OWNER/PRESIDENT)
(763) 497-0082
Entity
Organization

Contact information

Practice address
750 CENTRAL AVE E, SUITE 202, SAINT MICHAEL, MN 55376-4552
(763) 497-0082
(763) 497-0084
Mailing address
750 CENTRAL AVE E, SUITE 202, SAINT MICHAEL, MN 55376-4552
(763) 497-0082
(763) 497-0084

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
122E0200X
MN

Other

Enumeration date
08/27/2010
Last updated
08/27/2010
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