Provider Demographics
NPI:1669743738
Name:W H DENTAL, PLLC
Entity type:Organization
Organization Name:W H DENTAL, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST, CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WEINAND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:763-475-2000
Mailing Address - Street 1:17610 19TH AVE N
Mailing Address - Street 2:SUITE 8
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-2600
Mailing Address - Country:US
Mailing Address - Phone:763-475-2000
Mailing Address - Fax:763-475-2001
Practice Address - Street 1:17610 19TH AVE N
Practice Address - Street 2:SUITE 8
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-2600
Practice Address - Country:US
Practice Address - Phone:763-475-2000
Practice Address - Fax:763-475-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-22
Last Update Date:2012-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty