| Willmar Dental Clinic | |
|
1801 Technology Dr Ne Willmar MN 56201 | |
| (320) 231-5100 | |
| Not Available |
| Full Name | Willmar Dental Clinic |
|---|---|
| Speciality | Dentist - Dental Public Health |
| Location | 1801 Technology Dr Ne, Willmar, Minnesota |
| Authorized Official Name and Position | Victoria O Alabi (HUMAN SERVICE MANAGER) |
| Authorized Official Contact | 6514788002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willmar Dental Clinic Po Box 64979 Saint Paul MN 55164-0979 Ph: () - | Willmar Dental Clinic 1801 Technology Dr Ne Willmar MN 56201 Ph: (320) 231-5100 |
| NPI Number | 1811033061 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 09/04/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811033061 | NPI | - | NPPES |
| 243833000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | (* (Not Available)) | Primary |
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