Provider Demographics
NPI:1619345170
Name:A-TEAM ORTHODONTICS, PLLC
Entity Type:Organization
Organization Name:A-TEAM ORTHODONTICS, PLLC
Other - Org Name:ZAPFEL ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ALISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MADSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:612-703-8207
Mailing Address - Street 1:1130 COUNTY ROAD 10
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55432-1261
Mailing Address - Country:US
Mailing Address - Phone:763-784-0420
Mailing Address - Fax:
Practice Address - Street 1:1130 COUNTY ROAD 10
Practice Address - Street 2:
Practice Address - City:SPRING LAKE PARK
Practice Address - State:MN
Practice Address - Zip Code:55432-1261
Practice Address - Country:US
Practice Address - Phone:763-784-0420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND120911223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty