Gavren, Beth Ann

Gavren, Beth Ann is an individual health care provider with primary practice located at 15785 95Th Ave N , Maple Grove MN 55369-4404. She recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as her primary health care specialty. Gavren, Beth Ann can be contacted via phone (763) 233-4141.

Contact Information

Primary practice address
15785 95Th Ave N Maple Grove MN 55369-4404
Fax: (763) 420-5875
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X D11463 Minnesota

Profile Details

NPI number 1699764431
LBN Legal business name Gavren, Beth Ann
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 14th, 2005
Last updated Jun 28th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699764431 NPPES
Minnesota MEDICAID 8068330-00

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