Champlin Family Dental PA

NPI #1992818751 in Champlin, Minnesota

Provider Information

NPI Number: 1992818751
Entity Type: Organization
Organization Name: Champlin Family Dental PA
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 16, 2006
Last Updated: Apr 22, 2015

Practice Location

Address: 12233 CHAMPLIN DRIVE
City: Champlin
State: Minnesota
ZIP Code: 55316
Phone: (763) 323-0678

Authorized Official

Name: DR. KRISTA SUSAN BAUER, DDS
Title: DENTIST
Phone: (763) 323-0678

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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