| Prairie Lakes Family Dentistry | |
|
212 3rd St Tracy MN 56175-1214 | |
| (507) 212-0002 | |
| (507) 212-0020 |
| Full Name | Prairie Lakes Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 212 3rd St, Tracy, Minnesota |
| Authorized Official Name and Position | Jon Heezen (OWNER/DENTIST) |
| Authorized Official Contact | 5072120002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Lakes Family Dentistry Po Box 1174 Tracy MN 56175-0174 Ph: (507) 212-0002 | Prairie Lakes Family Dentistry 212 3rd St Tracy MN 56175-1214 Ph: (507) 212-0002 |
| NPI Number | 1780453589 |
|---|---|
| Provider Enumeration Date | 12/21/2023 |
| Last Update Date | 12/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780453589 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
3rd Street Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 212 3rd St Ste 5, Tracy, MN 56175 Phone: 507-626-8826 |