| Chisholm Dental Service Pa | |
|
217 1st St Nw Chisholm MN 55719-1701 | |
| (218) 254-3311 | |
| (218) 254-4531 |
| Full Name | Chisholm Dental Service Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 217 1st St Nw, Chisholm, Minnesota |
| Authorized Official Name and Position | Harold Goodman Swennes (DENTIST) |
| Authorized Official Contact | 2182543311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chisholm Dental Service Pa Po Box 632 Chisholm MN 55719-0632 Ph: (218) 254-3311 | Chisholm Dental Service Pa 217 1st St Nw Chisholm MN 55719-1701 Ph: (218) 254-3311 |
| NPI Number | 1396807012 |
|---|---|
| Provider Enumeration Date | 12/16/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396807012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 3613539 (Minnesota) | Primary |
Children's Dental Services Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 229 W Lake St, Chisholm, MN 55719 Phone: 612-746-1530 |