Kris Clifton Bomstad, DDS
Individual provider Active NPI General Practice Dentistry · Hopkins, MN
NPI 1184729436 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1184729436
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D11424 (MN)
- Practice address
- 911 1St St N
Hopkins, MN 55343 - Phone
- (952) 938-7746
- Fax
- (952) 938-1511
- NPI assigned
- Sep 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D11424 | MN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hatcher and Bomstad DDS LLC | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D11424 | MN | Yes |
Addresses
Primary practice location
911 1St St N
Hopkins, MN 55343
Mailing address
911 1St St N
Hopkins, MN 55343
Phone (952) 938-7746
Other providers in Hopkins, MN
- Best Choice Home Care LLC
- Better Care Medical, Incorporated
- Kristin Marie Binnicker
- Blake Transportation Company LLC
- Kelly Jean Blondell
- Steven Borchardt
- Lacey Borrell
- Julie Bowker
- Robert Boyat
- Lynn Newgent Bremner
All providers in Hopkins, MN · General Practice Dentistry in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.