| Whoolery Dentistry, P.c. | |
|
219 E Lincoln Ave Fergus Falls MN 56537-2236 | |
| (218) 739-2217 | |
| (218) 739-2443 |
| Full Name | Whoolery Dentistry, P.c. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 219 E Lincoln Ave, Fergus Falls, Minnesota |
| Authorized Official Name and Position | Stephen Paul Whoolery (PRESIDENT) |
| Authorized Official Contact | 2187392217 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Whoolery Dentistry, P.c. 219 E Lincoln Ave Fergus Falls MN 56537-2236 Ph: (218) 739-2217 | Whoolery Dentistry, P.c. 219 E Lincoln Ave Fergus Falls MN 56537-2236 Ph: (218) 739-2217 |
| NPI Number | 1396833554 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 05/29/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396833554 | NPI | - | NPPES |
| 954220500 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D9505 (Minnesota) | Primary |
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