| East Central Dental Clinic, Pa | |
|
110 5th St Nw Braham MN 55006-3015 | |
| (320) 396-4417 | |
| (320) 396-4417 |
| Full Name | East Central Dental Clinic, Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 110 5th St Nw, Braham, Minnesota |
| Authorized Official Name and Position | James A. Radziun (PRESIDENT) |
| Authorized Official Contact | 3203964417 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Central Dental Clinic, Pa Po Box 170 Braham MN 55006-0170 Ph: (320) 396-4417 | East Central Dental Clinic, Pa 110 5th St Nw Braham MN 55006-3015 Ph: (320) 396-4417 |
| NPI Number | 1871535344 |
|---|---|
| Provider Enumeration Date | 06/11/2006 |
| Last Update Date | 11/30/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871535344 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D9743 (Minnesota) | Primary |
Braham Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 5th St Nw, Braham, MN 55006 Phone: 651-470-9590 |