Avon Dental Clinic PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D10962 Issued in MN

Legal business name

AVON DENTAL CLINIC PA

Practice address

308A Blattner Drive
Avon, MN 56310

Phone

(320) 356-7374

Fax

(320) 356-9427

NPI assigned

Mar 2, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cheryl A Kalis

Title

Receptionist

Phone

(320) 356-7374

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196035200000",
    "number": "1922137447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308A BLATTNER DRIVE",
            "city": "AVON",
            "state": "MN",
            "postal_code": "56310",
            "telephone_number": "320-356-7374",
            "fax_number": "320-356-9427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308A BLATTNER DRIVE",
            "city": "AVON",
            "state": "MN",
            "postal_code": "56310",
            "telephone_number": "320-356-7374",
            "fax_number": "320-356-9427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVON DENTAL CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-11-26",
        "status": "A",
        "authorized_official_last_name": "KALIS",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "RECEPTIONIST",
        "authorized_official_telephone_number": "320-356-7374"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D10962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avon Dental PLLC
• Kathleen Alice Beuning, CNP
• Preston Bryant
• Central Minnesota Alarms, Inc,
• Alyssa Lynn Gullickson, D.D.S.

• General Practice Dentistry in Avon, MN
• Providers in Avon, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.