Provider Demographics
NPI:1316385487
Name:NORTHPOINTE DENTAL SLEEP MEDICINE
Entity Type:Organization
Organization Name:NORTHPOINTE DENTAL SLEEP MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:RATHJEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:763-780-1300
Mailing Address - Street 1:607 COUNTY ROAD 10 NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55434-2373
Mailing Address - Country:US
Mailing Address - Phone:763-780-1300
Mailing Address - Fax:763-785-7818
Practice Address - Street 1:607 COUNTY ROAD 10 NE
Practice Address - Street 2:SUITE 100
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55434-2373
Practice Address - Country:US
Practice Address - Phone:763-780-1300
Practice Address - Fax:763-785-7818
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHPOINTE DENTAL CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND8636332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies