Provider Demographics
NPI:1114013224
Name:ANGELL, DAVID WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WILLIAM
Last Name:ANGELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 40TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-3719
Mailing Address - Country:US
Mailing Address - Phone:763-788-2215
Mailing Address - Fax:763-788-1199
Practice Address - Street 1:427 40TH AVE NE
Practice Address - Street 2:
Practice Address - City:COLUMBIA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55421-3719
Practice Address - Country:US
Practice Address - Phone:763-788-2215
Practice Address - Fax:763-788-1199
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN87271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN9927OtherDORAL UCARE
MN00552ANOtherBLUE CROSS BLUE SHIELD
MN824317OtherUNITED CONCORDIA
MN824317OtherUNITED CONCORDIA