Provider Demographics
NPI:1447328232
Name:KORF, DANIEL J (DDS)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:KORF
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:PO BOX 445
Mailing Address - Street 2:
Mailing Address - City:FRAZEE
Mailing Address - State:MN
Mailing Address - Zip Code:56544-0445
Mailing Address - Country:US
Mailing Address - Phone:218-334-6000
Mailing Address - Fax:
Practice Address - Street 1:101 E ASH AVE
Practice Address - Street 2:
Practice Address - City:FRAZEE
Practice Address - State:MN
Practice Address - Zip Code:56544
Practice Address - Country:US
Practice Address - Phone:218-334-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN88311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice