| Balaton Dental Clinic,inc | |
|
123 3rd St Balaton MN 56115-9451 | |
| (507) 734-2251 | |
| (507) 734-2077 |
| Full Name | Balaton Dental Clinic,inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 123 3rd St, Balaton, Minnesota |
| Authorized Official Name and Position | Richard Wallace Brown (OWNER/DENTIST) |
| Authorized Official Contact | 5077342251 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Balaton Dental Clinic,inc 123 3rd St P.o.box 186 Balaton MN 56115-9451 Ph: (507) 734-2251 | Balaton Dental Clinic,inc 123 3rd St Balaton MN 56115-9451 Ph: (507) 734-2251 |
| NPI Number | 1982031878 |
|---|---|
| Provider Enumeration Date | 10/09/2013 |
| Last Update Date | 10/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982031878 | NPI | - | NPPES |
| 996822900 | Other | MN | MEDICAL ASSISTANCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 10227 (Minnesota) | Primary |