| Warroad Family Dentistry, Ltd | |
| 
					307 South State Ave Warroad MN 56763-0490  | |
| (218) 386-1048 | |
| (218) 386-1049 | 
| Full Name | Warroad Family Dentistry, Ltd | 
|---|---|
| Speciality | Dentist - General Practice | 
| Location | 307 South State Ave, Warroad, Minnesota | 
| Authorized Official Name and Position | Kathy Ann Thiele (CORPORATE SECRETARY) | 
| Authorized Official Contact | 2183861048 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Warroad Family Dentistry, Ltd Po Box 490 Warroad MN 56763-0490 Ph: (218) 386-1048  | Warroad Family Dentistry, Ltd 307 South State Ave Warroad MN 56763-0490 Ph: (218) 386-1048  | 
| NPI Number | 1497745400 | 
|---|---|
| Provider Enumeration Date | 10/21/2005 | 
| Last Update Date | 08/22/2020 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1497745400 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 9514 (Minnesota) | Primary | 
Northern Lights Family Dentistry,pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 603 Emily Ave. Nw, Warroad, MN 56763 Phone: 218-386-2889  |