Provider Demographics
NPI:1407275183
Name:APPLE TREE DENTAL
Entity Type:Organization
Organization Name:APPLE TREE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHUMACHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-784-7993
Mailing Address - Street 1:2442 MOUNDS VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:MOUNDS VIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55112
Mailing Address - Country:US
Mailing Address - Phone:763-316-5400
Mailing Address - Fax:763-780-9005
Practice Address - Street 1:2442 MOUNDS VIEW BLVD
Practice Address - Street 2:
Practice Address - City:MOUNDS VIEW
Practice Address - State:MN
Practice Address - Zip Code:55112
Practice Address - Country:US
Practice Address - Phone:763-316-5400
Practice Address - Fax:763-780-9005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-10
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty