| Headwaters Dental | |
|
2229 23rd St Nw Bemidji MN 56601-5503 | |
| (218) 333-6515 | |
| (218) 333-6519 |
| Full Name | Headwaters Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2229 23rd St Nw, Bemidji, Minnesota |
| Authorized Official Name and Position | Patricia Winslow Feil (DDS/OWNER) |
| Authorized Official Contact | 2183336515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Headwaters Dental 2229 23rd St Nw Bemidji MN 56601-5503 Ph: (218) 333-6515 | Headwaters Dental 2229 23rd St Nw Bemidji MN 56601-5503 Ph: (218) 333-6515 |
| NPI Number | 1558374561 |
|---|---|
| Provider Enumeration Date | 08/14/2006 |
| Last Update Date | 03/28/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558374561 | NPI | - | NPPES |
| 96501800 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Minnesota) | Primary |
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