| First Avenue Dental Pllc | |
|
74 1st Ave Se Little Falls MN 56345-3042 | |
| (320) 241-6927 | |
| Not Available |
| Full Name | First Avenue Dental Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 74 1st Ave Se, Little Falls, Minnesota |
| Authorized Official Name and Position | Zachary Steven Conklin (OWNER) |
| Authorized Official Contact | 3202416927 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| First Avenue Dental Pllc 720 Roberts Rd Apt 310 Sartell MN 56377-3403 Ph: (320) 241-6927 | First Avenue Dental Pllc 74 1st Ave Se Little Falls MN 56345-3042 Ph: (320) 241-6927 |
| NPI Number | 1336831445 |
|---|---|
| Provider Enumeration Date | 05/25/2023 |
| Last Update Date | 05/25/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336831445 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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