| Thomas Backenstose | |
|
417 Lincoln Ave Nw Faribault MN 55021-4952 | |
| (507) 332-7608 | |
| Not Available |
| Full Name | Thomas Backenstose |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 417 Lincoln Ave Nw, Faribault, Minnesota |
| Authorized Official Name and Position | Anne Meyer (OFFICE MANAGER) |
| Authorized Official Contact | 5073327608 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas Backenstose 417 Lincoln Ave Nw Faribault MN 55021-4952 Ph: () - | Thomas Backenstose 417 Lincoln Ave Nw Faribault MN 55021-4952 Ph: (507) 332-7608 |
| NPI Number | 1225196330 |
|---|---|
| Provider Enumeration Date | 12/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225196330 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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