| Shetek Dental Care Pa | |
|
106 2nd St Nw Fulda MN 56131 | |
| (507) 425-2276 | |
| (507) 425-2769 |
| Full Name | Shetek Dental Care Pa |
|---|---|
| Speciality | Dentist |
| Location | 106 2nd St Nw, Fulda, Minnesota |
| Authorized Official Name and Position | Narla Norine Hulstein (CLINIC MANAGER) |
| Authorized Official Contact | 5078361000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shetek Dental Care Pa 106 2nd St Nw Fulda MN 56131-1101 Ph: (507) 425-2276 | Shetek Dental Care Pa 106 2nd St Nw Fulda MN 56131 Ph: (507) 425-2276 |
| NPI Number | 1427455062 |
|---|---|
| Provider Enumeration Date | 11/25/2014 |
| Last Update Date | 11/25/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427455062 | NPI | - | NPPES |
| 1629187364 | Medicaid | MN | |
| 1881639201 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12229 (Minnesota) | Secondary |
| 122300000X | Dentist | 8209 (Minnesota) | Primary |