| Mississippi Headwaters Area Dental Health Center, Inc. | |
|
13 Main Ave N Bagley MN 56621-8315 | |
| (218) 694-6571 | |
| Not Available |
| Full Name | Mississippi Headwaters Area Dental Health Center, Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 13 Main Ave N, Bagley, Minnesota |
| Authorized Official Name and Position | Erica Anne Lundberg (DIRECTOR OF FINANCE AND OPERATIONS) |
| Authorized Official Contact | 2184449147 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mississippi Headwaters Area Dental Health Center, Inc. 1405 Anne St Nw Bemidji MN 56601-5113 Ph: (218) 444-9147 | Mississippi Headwaters Area Dental Health Center, Inc. 13 Main Ave N Bagley MN 56621-8315 Ph: (218) 694-6571 |
| NPI Number | 1225811102 |
|---|---|
| Provider Enumeration Date | 08/15/2023 |
| Last Update Date | 08/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225811102 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Bagley Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13 Main Ave N, Bagley, MN 56621 Phone: 218-964-6571 Fax: 218-694-6555 |