Provider Demographics
NPI:1932175585
Name:KNAFF, ERIC MATTHEW (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:MATTHEW
Last Name:KNAFF
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 1:2024 SELBY AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-5763
Mailing Address - Country:US
Mailing Address - Phone:651-470-2399
Mailing Address - Fax:
Practice Address - Street 1:1789 WOODLANE DR
Practice Address - Street 2:SUITE D
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-3910
Practice Address - Country:US
Practice Address - Phone:651-738-1284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND121371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice