Provider Demographics
NPI:1043765142
Name:NOESEN AND ASSOCIATES PA
Entity Type:Organization
Organization Name:NOESEN AND ASSOCIATES PA
Other - Org Name:DR. GEORGE NOESEN
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PEG
Authorized Official - Middle Name:
Authorized Official - Last Name:NOESEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-388-1806
Mailing Address - Street 1:608 TECHNOLOGY DR
Mailing Address - Street 2:
Mailing Address - City:RED WING
Mailing Address - State:MN
Mailing Address - Zip Code:55066-2846
Mailing Address - Country:US
Mailing Address - Phone:651-388-1806
Mailing Address - Fax:651-385-0432
Practice Address - Street 1:608 TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:RED WING
Practice Address - State:MN
Practice Address - Zip Code:55066-2846
Practice Address - Country:US
Practice Address - Phone:651-388-1806
Practice Address - Fax:651-385-0432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN98761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty