| Blackduck Dental Clinic | |
|
49 Summit Ave. Se Blackduck MN 56630 | |
| (218) 835-4227 | |
| (218) 835-7512 |
| Full Name | Blackduck Dental Clinic |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 49 Summit Ave. Se, Blackduck, Minnesota |
| Authorized Official Name and Position | Paul R Bengtson (DENTIST) |
| Authorized Official Contact | 2188354227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blackduck Dental Clinic Po Box 308 Blackduck MN 56630-0308 Ph: (218) 835-4227 | Blackduck Dental Clinic 49 Summit Ave. Se Blackduck MN 56630 Ph: (218) 835-4227 |
| NPI Number | 1003991944 |
|---|---|
| Provider Enumeration Date | 10/26/2006 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003991944 | NPI | - | NPPES |
| 81202BE | Other | MN | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7789 (Minnesota) | Primary |
Blackduck Dental Clinic Psc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 49 Summit Ave. E., Blackduck, MN 56630 Phone: 218-835-4227 |