Provider Demographics
NPI:1255491866
Name:INTEGRITY DENTAL CARE, P.A.
Entity Type:Organization
Organization Name:INTEGRITY DENTAL CARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:TREHARNE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:651-459-3039
Mailing Address - Street 1:7500 80TH ST S
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016
Mailing Address - Country:US
Mailing Address - Phone:651-459-3039
Mailing Address - Fax:651-459-9874
Practice Address - Street 1:7500 80TH ST S
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55016
Practice Address - Country:US
Practice Address - Phone:651-459-3039
Practice Address - Fax:651-459-9874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8108122300000X
MN10404122300000X
MN10522122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty