| Moorse Dental Psc | |
| 
					907 W Lincoln Ave Olivia MN 56277-4215  | |
| (320) 523-1441 | |
| (320) 523-1441 | 
| Full Name | Moorse Dental Psc | 
|---|---|
| Speciality | Dentist | 
| Location | 907 W Lincoln Ave, Olivia, Minnesota | 
| Authorized Official Name and Position | Mark Joseph Moorse (PRESIDENT) | 
| Authorized Official Contact | 3205231441 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Moorse Dental Psc 907 W Lincoln Ave Olivia MN 56277-4215 Ph: (320) 523-1441  | Moorse Dental Psc 907 W Lincoln Ave Olivia MN 56277-4215 Ph: (320) 523-1441  | 
| NPI Number | 1073594891 | 
|---|---|
| Provider Enumeration Date | 11/09/2005 | 
| Last Update Date | 11/24/2009 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1073594891 | NPI | - | NPPES | 
| 120523400 | Medicaid | MN | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 122300000X | Dentist | D11030 (Minnesota) | Primary |