| Mark L Ohlsen | |
|
505 4th St Nw Faribault MN 55021 | |
| (507) 334-7471 | |
| (507) 334-9736 |
| Full Name | Mark L Ohlsen |
|---|---|
| Speciality | Dentist |
| Location | 505 4th St Nw, Faribault, Minnesota |
| Authorized Official Name and Position | Mark L Ohlsen (OWNER) |
| Authorized Official Contact | 5073347471 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark L Ohlsen 505 4th St Nw Faribault MN 55021 Ph: (507) 334-7471 | Mark L Ohlsen 505 4th St Nw Faribault MN 55021 Ph: (507) 334-7471 |
| NPI Number | 1740397611 |
|---|---|
| Provider Enumeration Date | 08/24/2006 |
| Last Update Date | 06/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740397611 | NPI | - | NPPES |
| 273522900 | Other | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D 10296 (Minnesota) | Primary |
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