Pine River Dental Arts, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D13283 Issued in MN

Legal business name

PINE RIVER DENTAL ARTS, P.C.

Practice address

203 Park Ave
Pine River, MN 56474

Phone

(218) 587-4437

Fax

(218) 587-4479

NPI assigned

Jun 9, 2016

Organization subpart

No

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

Authorized official

Name

Jaime Lyn Preble, DDS

Title

Owner

Phone

(218) 587-4437

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465430400000",
    "number": "1962851071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650",
            "city": "PINE RIVER",
            "state": "MN",
            "postal_code": "564740650",
            "telephone_number": "218-587-4437",
            "fax_number": "218-587-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 PARK AVE",
            "city": "PINE RIVER",
            "state": "MN",
            "postal_code": "56474",
            "telephone_number": "218-587-4437",
            "fax_number": "218-587-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE RIVER DENTAL ARTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-06-09",
        "status": "A",
        "authorized_official_last_name": "PREBLE",
        "authorized_official_first_name": "JAIME",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-587-4437",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaelyn Elizabeth Kappes, PHARMD
• Lakes Area Pharmacy
• Michael S Marvin, O.D.
• Northwoods Dna, Inc.
• Taylor Anne Ott, PHARMD
• Pine River Dental Center LLC
• Pine River Dental Center LLC
• Pine River Eye Center, Inc.
• Annette M Pohl, LPT
• Jaime Lyn Preble, DDS

• General Practice Dentistry in Pine River, MN
• Providers in Pine River, 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 Jun 9, 2016; 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.