Organization
DR. DENNIS L. NIERENGARTEN, D.D.S., P.A.
Active
Other names
Excellence Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS LEE NIERENGARTEN D.D.S., P.A. (OWNER/DENTIST)
(320) 255-1020
Entity
Organization
Contact information
Practice address
1511 NORTHWAY DR STE 102, SAINT CLOUD, MN 56303-1262
(320) 255-1020
(320) 255-1020
Mailing address
1511 NORTHWAY DR STE 102, SAINT CLOUD, MN 56303-1262
(320) 255-1020
(320) 255-1020
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
D9004
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023043205
ASSOCIATE DR PERSONAL NPI
MN
01
—
1487691887
DR. PERSONAL NPI TYPE 1
MN
Enumeration date
06/10/2010
Last updated
06/10/2010
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