Provider Demographics
NPI:1346818648
Name:KAJER, MATTHEW (DMD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:KAJER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1736 COPE AVE E
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55109-2610
Mailing Address - Country:US
Mailing Address - Phone:651-770-3831
Mailing Address - Fax:
Practice Address - Street 1:1736 COPE AVE E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55109-2610
Practice Address - Country:US
Practice Address - Phone:651-770-3831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND145831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice