| The Salvation Army Good Samaritan Dental Clinic | |
|
120 N Broadway Ste B Rochester MN 55906-3728 | |
| (507) 529-4100 | |
| (507) 529-4101 |
| Full Name | The Salvation Army Good Samaritan Dental Clinic |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 120 N Broadway Ste B, Rochester, Minnesota |
| Authorized Official Name and Position | Allison Uthke-scaletta (GOVERNMENT GRANTWRITER) |
| Authorized Official Contact | 6517463543 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Salvation Army Good Samaritan Dental Clinic 20 1st Ave Ne Rochester MN 55906-3706 Ph: (507) 529-4100 | The Salvation Army Good Samaritan Dental Clinic 120 N Broadway Ste B Rochester MN 55906-3728 Ph: (507) 529-4100 |
| NPI Number | 1093882656 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 12/02/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093882656 | NPI | - | NPPES |
| 867910000 | Other | MN | PROVIDER IDENTIFICATION # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 867910000 (Minnesota) | Primary |
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