| Dipaul Dental, Pc | |
| 
					2219 Paul Bunyan Dr Nw Ste 6-7 Bemidji MN 56601-6188  | |
| (218) 751-2659 | |
| (218) 751-1806 | 
| Full Name | Dipaul Dental, Pc | 
|---|---|
| Speciality | Dentist - General Practice | 
| Location | 2219 Paul Bunyan Dr Nw Ste 6-7, Bemidji, Minnesota | 
| Authorized Official Name and Position | Kim Van Camp (PROVIDER ENROLLMENT SPECIALIST) | 
| Authorized Official Contact | 3154546000 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dipaul Dental, Pc Po Box 3189 Syracuse NY 13220-3189 Ph: (315) 454-6000  | Dipaul Dental, Pc 2219 Paul Bunyan Dr Nw Ste 6-7 Bemidji MN 56601-6188 Ph: (218) 751-2659  | 
| NPI Number | 1508252578 | 
|---|---|
| Provider Enumeration Date | 04/07/2015 | 
| Last Update Date | 04/07/2015 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1508252578 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 13499 (Minnesota) | Primary | 
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