| Northern Dental Partners And Associates Pllc | |
|
1121 Se 4th Ave Grand Rapids MN 55744-3956 | |
| (218) 326-3437 | |
| (218) 327-1211 |
| Full Name | Northern Dental Partners And Associates Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1121 Se 4th Ave, Grand Rapids, Minnesota |
| Authorized Official Name and Position | Peter John Miskovich (DENTIST/PARTNER) |
| Authorized Official Contact | 2183263437 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Dental Partners And Associates Pllc 1121 Se 4th Ave Grand Rapids MN 55744-3956 Ph: (218) 326-3437 | Northern Dental Partners And Associates Pllc 1121 Se 4th Ave Grand Rapids MN 55744-3956 Ph: (218) 326-3437 |
| NPI Number | 1396497434 |
|---|---|
| Provider Enumeration Date | 01/20/2022 |
| Last Update Date | 01/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396497434 | NPI | - | NPPES |
| 274L7MI27SL | Other | MN | BCBS |
| 842936700 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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