HANOVER DENTAL – NPI #1487147260
Clinic/Center

HANOVER DENTAL is an AHC clinic located in HANOVER, MN. NPPES has assigned the NPI number 1487147260 to HANOVER DENTAL on June 07, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “HANOVER DENTAL” is a dba name, the actual legal business name for this organization is HANOVER DENTAL PLLC. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for HANOVER DENTAL below.

NPI Profile for
HANOVER DENTAL PLLC

NPI Number
1487147260
Enumeration Date

(more than 8 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
HANOVER DENTAL PLLC
Doing Business As (dba): HANOVER DENTAL
Primary location
411 LABEAUX AVE NE
HANOVER, MN 55341
Phone: (763) 400-3005 Fax:
Mailing address
1192 BICE AVE NW
BUFFALO, MN 55313-4456
Phone: (763) 226-7379 Fax:
Organization Subpart
No
Authorized Official
TYLER KOIVISTO
DENTIST
Phone: (763) 226-7379
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)		 MN D13236

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.