| Aspen Dental | |
|
2219 Paul Bunyan Dr Nw Ste 6-7 Bemidji MN 56601-6188 | |
| (218) 751-2659 | |
| (218) 751-1806 |
| Full Name | Aspen Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2219 Paul Bunyan Dr Nw Ste 6-7, Bemidji, Minnesota |
| Authorized Official Name and Position | Kim Van Camp (PROVIDER ENROLLMENT SPECIALIST) |
| Authorized Official Contact | 3154546000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aspen Dental Po Box 3189 Syracuse NY 13220-3189 Ph: (315) 454-6000 | Aspen Dental 2219 Paul Bunyan Dr Nw Ste 6-7 Bemidji MN 56601-6188 Ph: (218) 751-2659 |
| NPI Number | 1508252578 |
|---|---|
| Provider Enumeration Date | 04/07/2015 |
| Last Update Date | 04/07/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508252578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 13499 (Minnesota) | Primary |
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