| State Of Minnesota - Minnesota Management And Budget | |
| 
					920 Anne St Nw Bemidji MN 56601-5104  | |
| (651) 396-6260 | |
| Not Available | 
| Full Name | State Of Minnesota - Minnesota Management And Budget | 
|---|---|
| Speciality | Dentist - General Practice | 
| Location | 920 Anne St Nw, Bemidji, Minnesota | 
| Authorized Official Name and Position | Simone Renee Hogan (MDVA HEALTHCARE OPERATIONS DIRECTOR) | 
| Authorized Official Contact | 6125054110 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| State Of Minnesota - Minnesota Management And Budget 5101 Minnehaha Ave Bldg 10 Minneapolis MN 55417-1647 Ph: (651) 396-6260  | State Of Minnesota - Minnesota Management And Budget 920 Anne St Nw Bemidji MN 56601-5104 Ph: (651) 396-6260  | 
| NPI Number | 1144036393 | 
|---|---|
| Provider Enumeration Date | 12/03/2024 | 
| Last Update Date | 12/03/2024 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1144036393 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary | 
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