Provider Demographics
NPI:1518033166
Name:ARNESEN & HERBERT DDS
Entity Type:Organization
Organization Name:ARNESEN & HERBERT DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:ARNESEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-475-2820
Mailing Address - Street 1:1525 CO RD 101 N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447
Mailing Address - Country:US
Mailing Address - Phone:763-475-2820
Mailing Address - Fax:763-475-1037
Practice Address - Street 1:1525 CO RD 101 N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447
Practice Address - Country:US
Practice Address - Phone:763-475-2820
Practice Address - Fax:763-475-1037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN89791223G0001X
MN100131223G0001X
MN114551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty