| Northland Smiles Corporation Pa | |
|
21343 Archibald Road Deerwood MN 56444 | |
| (218) 534-3141 | |
| Not Available |
| Full Name | Northland Smiles Corporation Pa |
|---|---|
| Speciality | Clinic/center |
| Location | 21343 Archibald Road, Deerwood, Minnesota |
| Authorized Official Name and Position | Kendall Lewis Dammeier (OWNER) |
| Authorized Official Contact | 2185343141 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northland Smiles Corporation Pa Po Box 385 Deerwood MN 56444-0385 Ph: (218) 534-3141 | Northland Smiles Corporation Pa 21343 Archibald Road Deerwood MN 56444 Ph: (218) 534-3141 |
| NPI Number | 1043567357 |
|---|---|
| Provider Enumeration Date | 08/07/2012 |
| Last Update Date | 08/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043567357 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
St Joseph's Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 24087 Cuyuna St, Deerwood, MN 56444 Phone: 218-833-5160 Fax: 218-833-5169 | |
Deerwood Dental, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 21343 Archibald Road, Deerwood, MN 56444 Phone: 218-534-3141 Fax: 218-534-3949 |