| Advanced Family Dental Pa | |
|
2717 Ekko Ave Albert Lea MN 56007-2070 | |
| (507) 373-5968 | |
| (507) 540-1395 |
| Full Name | Advanced Family Dental Pa |
|---|---|
| Speciality | Dentist |
| Location | 2717 Ekko Ave, Albert Lea, Minnesota |
| Authorized Official Name and Position | Rachel Anne Poppel (OWNER) |
| Authorized Official Contact | 5073735968 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Family Dental Pa 2717 Ekko Ave Albert Lea MN 56007-2070 Ph: (507) 373-5968 | Advanced Family Dental Pa 2717 Ekko Ave Albert Lea MN 56007-2070 Ph: (507) 373-5968 |
| NPI Number | 1548540321 |
|---|---|
| Provider Enumeration Date | 08/24/2011 |
| Last Update Date | 04/13/2020 |
| Medicare PECOS PAC ID | 2860822640 |
|---|---|
| Medicare Enrollment ID | O20200417002947 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548540321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D12409 (Minnesota) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
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