Chisholm Dental Service Pa | |
217 1st St Nw Chisholm MN 55719-1701 | |
(218) 254-3311 | |
(218) 254-4531 |
Full Name | Chisholm Dental Service Pa |
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Speciality | Clinic/center - Dental |
Location | 217 1st St Nw, Chisholm, Minnesota |
Authorized Official Name and Position | Harold Goodman Swennes (DENTIST) |
Authorized Official Contact | 2182543311 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Chisholm Dental Service Pa Po Box 632 Chisholm MN 55719-0632 Ph: (218) 254-3311 | Chisholm Dental Service Pa 217 1st St Nw Chisholm MN 55719-1701 Ph: (218) 254-3311 |
NPI Number | 1396807012 |
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Provider Enumeration Date | 12/16/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1396807012 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 3613539 (Minnesota) | Primary |
Children's Dental Services Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 229 W Lake St, Chisholm, MN 55719 Phone: 612-746-1530 |