Byron Dental Group Pa | |
21 Ne Frontage Rd. Byron MN 55920 | |
(507) 775-6445 | |
(507) 775-6446 |
Full Name | Byron Dental Group Pa |
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Speciality | Dentist |
Location | 21 Ne Frontage Rd., Byron, Minnesota |
Authorized Official Name and Position | Lori Lee Stackhouse (OFFICE MANAGER) |
Authorized Official Contact | 5077756445 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Byron Dental Group Pa P.o. Box 37 21 Ne Frontage Rd., Byron MN 55920 Ph: (507) 775-6445 | Byron Dental Group Pa 21 Ne Frontage Rd. Byron MN 55920 Ph: (507) 775-6445 |
NPI Number | 1477888949 |
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Provider Enumeration Date | 10/16/2009 |
Last Update Date | 12/11/2019 |
Medicare PECOS PAC ID | 7719311026 |
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Medicare Enrollment ID | O20191219001150 |
Identifier | Type | State | Issuer |
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1477888949 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | (* (Not Available)) | Primary |
Provider Name | Heidi K Torgerson |
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Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1700050549 PECOS PAC ID: 0648586883 Enrollment ID: I20191219001629 |
Northwest Dental Group Of Rochester Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 Frontage Rd Ne, Byron, MN 55920 Phone: 507-289-3921 |