ALEX PROVO

Dentist · ADA, MN

Individual Active Opted out of Medicare NPI 1750762555

Taxonomy & licensure

Specialty	Code	Primary	License	State
Dentist	122300000X	✓	D13521	MN

Medicare eligibility

Part B: Yes
DME: Yes
Home health: Yes
Power mobility: No
Hospice: Yes

Opted out of Medicare (Dentist), effective 2016-01-05 through 2028-01-05.

Other Dentist providers in Minnesota

12TH STREET DENTAL OFFICE PA
ROCHESTER
NPI 1043374176
3RD STREET DENTAL LLC
TRACY
NPI 1386335602
901 FAMILY DENTISTRY P.A.
MINNEAPOLIS
NPI 1689847519
A DAVID FLOR DDS LTD
ALBERT LEA
NPI 1508969692
A GENTLE DENTAL CENTER P.A.
ROBBINSDALE
NPI 1306933577
AARON SWINGDORF, DDS
NORTHFIELD
NPI 1154615847
AARON NISLEY, DDS
MINNEAPOLIS
NPI 1295391001
AARON TSAY
SPRING PARK
NPI 1629451000

See all Dentist providers in Minnesota →

Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.