| Kittson Dental Clinic Pa | |
|
1010 South Birch Hallock MN 56728 | |
| (218) 843-3343 | |
| (218) 843-8053 |
| Full Name | Kittson Dental Clinic Pa |
|---|---|
| Speciality | Dentist |
| Location | 1010 South Birch, Hallock, Minnesota |
| Authorized Official Name and Position | Travis Ammen Hanel (OWNER ONLY SHAREHOLDER) |
| Authorized Official Contact | 2188433343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kittson Dental Clinic Pa 1010 South Birch Hallock MN 56728 Ph: (218) 843-3343 | Kittson Dental Clinic Pa 1010 South Birch Hallock MN 56728 Ph: (218) 843-3343 |
| NPI Number | 1144303256 |
|---|---|
| Provider Enumeration Date | 10/23/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144303256 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D12024 (Minnesota) | Primary |