Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | D8756 | MN |
NPI | 1003874462 |
---|---|
Provider Name | Dr. Richard William Topel |
First Address | Maple Grove, MN 55369-6307 |
Second Address | Maple Grove, MN 55369-6307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 12/05/2008 |