| Correctional Dentistry, LLC | |
|
3152 County Road 74 Saint Cloud MN 56301-8904 | |
| (320) 774-3131 | |
| (320) 217-2877 |
| Full Name | Correctional Dentistry, LLC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3152 County Road 74, Saint Cloud, Minnesota |
| Authorized Official Name and Position | Julie Ann Benoit (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 3207743131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Correctional Dentistry, LLC 3152 County Road 74 Saint Cloud MN 56301-8904 Ph: (320) 774-3131 | Correctional Dentistry, LLC 3152 County Road 74 Saint Cloud MN 56301-8904 Ph: (320) 774-3131 |
| NPI Number | 1326767237 |
|---|---|
| Provider Enumeration Date | 08/24/2022 |
| Last Update Date | 08/24/2022 |
| Certification Date | 08/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326767237 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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