Provider Demographics
NPI:1811018591
Name:WINN, GEORGE (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:WINN
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 1:301 MAIN ST E
Mailing Address - Street 2:SUITE 2
Mailing Address - City:NEW PRAGUE
Mailing Address - State:MN
Mailing Address - Zip Code:56071-1803
Mailing Address - Country:US
Mailing Address - Phone:952-758-2376
Mailing Address - Fax:952-758-8708
Practice Address - Street 1:301 MAIN ST E
Practice Address - Street 2:SUITE 2
Practice Address - City:NEW PRAGUE
Practice Address - State:MN
Practice Address - Zip Code:56071-1803
Practice Address - Country:US
Practice Address - Phone:952-758-2376
Practice Address - Fax:952-758-8708
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND7142122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist