| Compass Dental Pa | |
|
114 3rd St N Cannon Falls MN 55009-2011 | |
| (507) 263-4501 | |
| Not Available |
| Full Name | Compass Dental Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 114 3rd St N, Cannon Falls, Minnesota |
| Authorized Official Name and Position | Daniel Curtis Callstrom (OWNER) |
| Authorized Official Contact | 5072634501 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Compass Dental Pa 114 3rd St N Cannon Falls MN 55009-2011 Ph: (507) 263-4501 | Compass Dental Pa 114 3rd St N Cannon Falls MN 55009-2011 Ph: (507) 263-4501 |
| NPI Number | 1932644648 |
|---|---|
| Provider Enumeration Date | 01/04/2017 |
| Last Update Date | 01/04/2017 |
| Medicare PECOS PAC ID | 9032547997 |
|---|---|
| Medicare Enrollment ID | O20200309000544 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932644648 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D11112 (Minnesota) | Primary |
| Provider Name | Daniel C Callstrom |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1356343230 PECOS PAC ID: 3577844257 Enrollment ID: I20200309000684 |
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