Provider Demographics
NPI:1992829063
Name:GRABNER, WALTER RICHARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:RICHARD
Last Name:GRABNER
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 1:29 - 9TH AVENUE NORTH
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-8087
Mailing Address - Country:US
Mailing Address - Phone:952-938-7341
Mailing Address - Fax:952-938-9361
Practice Address - Street 1:29 - 9TH AVENUE NORTH
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-8087
Practice Address - Country:US
Practice Address - Phone:952-938-7341
Practice Address - Fax:952-938-9361
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4925122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist