| Elko-new Market Dental Clinic | |
|
730 Main St Suite 2 Elko MN 55020-9701 | |
| (952) 461-5113 | |
| Not Available |
| Full Name | Elko-new Market Dental Clinic |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 730 Main St, Elko, Minnesota |
| Authorized Official Name and Position | Steven Blaine Petersen (OWNER) |
| Authorized Official Contact | 9524615113 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elko-new Market Dental Clinic Po Box 136 New Market MN 55054-0136 Ph: (952) 461-5113 | Elko-new Market Dental Clinic 730 Main St Suite 2 Elko MN 55020-9701 Ph: (952) 461-5113 |
| NPI Number | 1184835027 |
|---|---|
| Provider Enumeration Date | 05/24/2007 |
| Last Update Date | 07/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184835027 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D10525 (Minnesota) | Primary |