Bengtson, Paul Roy

Bengtson, Paul Roy is an sole proprietor health care provider with primary practice located at 49 Summit Ave E , Blackduck MN 56630. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Bengtson, Paul Roy can be contacted via phone (218) 835-4227.

Contact Information

Primary practice address
49 Summit Ave E Blackduck MN 56630
Fax: (218) 835-7512
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 7789 Minnesota

Profile Details

NPI number 1225203359
LBN Legal business name Bengtson, Paul Roy
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 29th, 2008
Last updated Apr 29th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225203359 NPPES
Minnesota MEDICAID 141818100

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