Engstrand, Gordon Dale

Engstrand, Gordon Dale is an sole proprietor health care provider with primary practice located at 2000 Plymouth Rd Suite 357, Minnetonka MN 55305-2366. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Engstrand, Gordon Dale can be contacted via phone (952) 544-1449.

Contact Information

Primary practice address
2000 Plymouth Rd Suite 357 Minnetonka MN 55305-2366
Phone: (952) 544-1449
Fax: (952) 544-7656
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D9825 Minnesota

Profile Details

NPI number 1922150770
LBN Legal business name Engstrand, Gordon Dale
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 18th, 2007
Last updated Jul 8th, 2007 - 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 1922150770 NPPES
Minnesota Other D253899 CIGNA HMO

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