Provider Demographics
NPI:1992807333
Name:CHARLES L HIRT DDS PA
Entity type:Organization
Organization Name:CHARLES L HIRT DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:HIRT
Authorized Official - Suffix:SR
Authorized Official - Credentials:DDS
Authorized Official - Phone:952-474-5239
Mailing Address - Street 1:17705 HUTCHINS DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345
Mailing Address - Country:US
Mailing Address - Phone:952-474-5239
Mailing Address - Fax:952-474-9401
Practice Address - Street 1:17705 HUTCHINS DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345
Practice Address - Country:US
Practice Address - Phone:952-474-5239
Practice Address - Fax:952-474-9401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty