| Downtown Dental Care Pa | |
|
304 Elm Ave Moose Lake MN 55767 | |
| (218) 485-4455 | |
| (218) 485-0227 |
| Full Name | Downtown Dental Care Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 304 Elm Ave, Moose Lake, Minnesota |
| Authorized Official Name and Position | Kurt David Stodola (DOCTOR VICE PRESIDENT) |
| Authorized Official Contact | 2184854455 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Downtown Dental Care Pa Po Box 587 304 Elm Ave Moose Lake MN 55767 Ph: (218) 485-4455 | Downtown Dental Care Pa 304 Elm Ave Moose Lake MN 55767 Ph: (218) 485-4455 |
| NPI Number | 1073674529 |
|---|---|
| Provider Enumeration Date | 12/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073674529 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |