| Hancock Dental Clinic, Pa | |
|
657 Atlantic Ave Hancock MN 56244-2104 | |
| (320) 392-5300 | |
| (320) 392-5302 |
| Full Name | Hancock Dental Clinic, Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 657 Atlantic Ave, Hancock, Minnesota |
| Authorized Official Name and Position | Timothy J Carlson (OWNER/PRESIDENT) |
| Authorized Official Contact | 3203925300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hancock Dental Clinic, Pa 657 Atlantic Ave Po Box 395 Hancock MN 56244-2104 Ph: (320) 392-5300 | Hancock Dental Clinic, Pa 657 Atlantic Ave Hancock MN 56244-2104 Ph: (320) 392-5300 |
| NPI Number | 1003278870 |
|---|---|
| Provider Enumeration Date | 03/22/2016 |
| Last Update Date | 03/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003278870 | NPI | - | NPPES |
| 1306931720 | Other | MN | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D10212 (Minnesota) | Primary |