Provider Demographics
NPI:1205548385
Name:WESTVIEW DENTISTRY, PLLC
Entity type:Organization
Organization Name:WESTVIEW DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:GARDETTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-252-8363
Mailing Address - Street 1:1521 NORTHWAY DRIVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ST CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303
Mailing Address - Country:US
Mailing Address - Phone:320-252-8363
Mailing Address - Fax:
Practice Address - Street 1:1521 NORTHWAY DRIVE
Practice Address - Street 2:SUITE 105
Practice Address - City:ST CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303
Practice Address - Country:US
Practice Address - Phone:320-252-8363
Practice Address - Fax:320-252-9962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty