Provider Demographics
NPI:1790948883
Name:TROBEC, PAUL MICHAEL (DDS)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:MICHAEL
Last Name:TROBEC
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 190
Mailing Address - Street 2:20 16TH AVE SW
Mailing Address - City:RICE
Mailing Address - State:MN
Mailing Address - Zip Code:56367
Mailing Address - Country:US
Mailing Address - Phone:320-393-2215
Mailing Address - Fax:320-393-3235
Practice Address - Street 1:20 16TH AVE. SW
Practice Address - Street 2:
Practice Address - City:RICE
Practice Address - State:MN
Practice Address - Zip Code:56367
Practice Address - Country:US
Practice Address - Phone:320-393-2215
Practice Address - Fax:320-393-3235
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND125441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice