Campodonico, Carlos Ernesto
Campodonico, Carlos Ernesto is an individual health care provider with primary practice located at 11806 Aberdeen St Ne Ste 150 , Blaine MN 55449-4748. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Campodonico, Carlos Ernesto can be contacted via phone (763) 786-1545.Contact Information
Primary practice address
11806 Aberdeen St Ne Ste 150
Blaine MN 55449-4748
Phone: (763) 786-1545
Fax: (763) 786-2939
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D12159 | Minnesota |
Profile Details
| NPI number | 1154546877 |
|---|---|
| LBN Legal business name | Campodonico, Carlos Ernesto |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 16th, 2007 |
| Last updated | Aug 2nd, 2016 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154546877 | NPPES |
| Minnesota | MEDICAID | 767695000 |
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