| Deer River Dental Clinic | |
|
111 Main Street E Deer River MN 56636 | |
| (218) 246-8200 | |
| Not Available |
| Full Name | Deer River Dental Clinic |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 111 Main Street E, Deer River, Minnesota |
| Authorized Official Name and Position | Jeffrey Lee Ccarter (DENTIST/OWNER) |
| Authorized Official Contact | 2182468200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Deer River Dental Clinic Po Box 40 Deer River MN 56636-0040 Ph: (218) 246-8200 | Deer River Dental Clinic 111 Main Street E Deer River MN 56636 Ph: (218) 246-8200 |
| NPI Number | 1417464157 |
|---|---|
| Provider Enumeration Date | 01/03/2018 |
| Last Update Date | 01/03/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417464157 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | D9499 (Minnesota) | Primary |