Provider Demographics
NPI:1457421786
Name:EHLERS AND KELLER DDS PA
Entity Type:Organization
Organization Name:EHLERS AND KELLER DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:EHLERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:612-861-7188
Mailing Address - Street 1:1537 E 66TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-2663
Mailing Address - Country:US
Mailing Address - Phone:612-861-7188
Mailing Address - Fax:612-861-1274
Practice Address - Street 1:1537 E 66TH ST
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2663
Practice Address - Country:US
Practice Address - Phone:612-861-7188
Practice Address - Fax:612-861-1274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND89281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty