| Prairie Dental Centers Pa | |
|
200 E Main St Ada MN 56510 | |
| (218) 784-7119 | |
| (218) 784-2381 |
| Full Name | Prairie Dental Centers Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 200 E Main St, Ada, Minnesota |
| Authorized Official Name and Position | David Resnick (CFO) |
| Authorized Official Contact | 2187847119 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Dental Centers Pa 200 E Main St Ada MN 56510 Ph: (218) 784-7119 | Prairie Dental Centers Pa 200 E Main St Ada MN 56510 Ph: (218) 784-7119 |
| NPI Number | 1447310636 |
|---|---|
| Provider Enumeration Date | 12/11/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447310636 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 10680 (Minnesota) | Secondary |
| 1223G0001X | Dentist - General Practice | 10681 (Minnesota) | Primary |