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DR. GREGORY RAYMOND DVORAK DDS

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1811082225

Individual Registrant:
DR. GREGORY RAYMOND DVORAK DDS
Gender: M
Sole Proprietor

Location and contact information for practice:
136 W. MAIN ST  NEW PRAGUE, MN 56071 US
Tel: 952-758-3003  Fax: 952-758-1939

Contact information for business:
136 W. MAIN ST  NEW PRAGUE, MN 56071 US
Tel: 952-758-3003  Fax: 952-758-1939

Registration Information:
NPI: 1811082225
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
MN8351

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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