| F C Requa Dds Pa | |
|
400 3rd Ave Nw Austin MN 55912 | |
| (507) 433-1641 | |
| Not Available |
| Full Name | F C Requa Dds Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 400 3rd Ave Nw, Austin, Minnesota |
| Authorized Official Name and Position | Frederick C Requa (PRES) |
| Authorized Official Contact | 5074331641 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| F C Requa Dds Pa 400 3rd Ave Nw Austin MN 55912 Ph: (507) 433-1641 | F C Requa Dds Pa 400 3rd Ave Nw Austin MN 55912 Ph: (507) 433-1641 |
| NPI Number | 1407930415 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407930415 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 6155 (Minnesota) | Primary |
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