| Lone Oak Family Dentistry | |
|
205 W Johnson Ave Ste. 3 Warren MN 56762-1118 | |
| (218) 745-4601 | |
| (218) 745-4600 |
| Full Name | Lone Oak Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 205 W Johnson Ave, Warren, Minnesota |
| Authorized Official Name and Position | Travis Ammen Hanel (DENTIST) |
| Authorized Official Contact | 2187454601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lone Oak Family Dentistry 205 W Johnson Ave Ste. 3 Warren MN 56762-1118 Ph: (218) 745-4601 | Lone Oak Family Dentistry 205 W Johnson Ave Ste. 3 Warren MN 56762-1118 Ph: (218) 745-4601 |
| NPI Number | 1053739698 |
|---|---|
| Provider Enumeration Date | 04/01/2014 |
| Last Update Date | 04/01/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053739698 | NPI | - | NPPES |
| 473990600 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D12024 (Minnesota) | Primary |