Organization
CHAMPLIN FAMILY DENTAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTA SUSAN BAUER DDS (DENTIST)
(763) 323-0678
Entity
Organization
Contact information
Practice address
12233 CHAMPLIN DRIVE, CHAMPLIN, MN 55316
(763) 323-0678
(763) 323-9102
Mailing address
12233 CHAMPLIN DRIVE, CHAMPLIN, MN 55316
(763) 323-0678
(763) 323-9102
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
11195
MN
1223G0001X
General Practice Dentistry
Primary
9624
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
624020800
MEDICAL ASSISTANCE TAX
MN
Enumeration date
08/16/2006
Last updated
04/22/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us