| Prairie Pines Dental, Pllc | |
|
109 Johnson Ave N Fosston MN 56542-1327 | |
| (320) 309-5882 | |
| Not Available |
| Full Name | Prairie Pines Dental, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 109 Johnson Ave N, Fosston, Minnesota |
| Authorized Official Name and Position | Karissa Goetsch (OWNER DENTIST) |
| Authorized Official Contact | 3203095882 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Pines Dental, Pllc 109 Johnson Ave N Fosston MN 56542-1327 Ph: () - | Prairie Pines Dental, Pllc 109 Johnson Ave N Fosston MN 56542-1327 Ph: (320) 309-5882 |
| NPI Number | 1578291803 |
|---|---|
| Provider Enumeration Date | 08/14/2022 |
| Last Update Date | 08/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578291803 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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