| Fond Du Lac Human Services Division Dental Clinic | |
|
927 Trettel Lane Fond Du Lac Human Services Division Dental Clinic Cloquet MN 55720 | |
| (218) 879-1227 | |
| (218) 878-3755 |
| Full Name | Fond Du Lac Human Services Division Dental Clinic |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 927 Trettel Lane, Cloquet, Minnesota |
| Authorized Official Name and Position | Karen R Diver (CHAIRWOMAN) |
| Authorized Official Contact | 2188794593 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fond Du Lac Human Services Division Dental Clinic 927 Trettel Lane Fond Du Lac Human Services Division Dental Clinic Cloquet MN 55720 Ph: (218) 879-1227 | Fond Du Lac Human Services Division Dental Clinic 927 Trettel Lane Fond Du Lac Human Services Division Dental Clinic Cloquet MN 55720 Ph: (218) 879-1227 |
| NPI Number | 1063723138 |
|---|---|
| Provider Enumeration Date | 06/23/2010 |
| Last Update Date | 06/23/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063723138 | NPI | - | NPPES |
| 666815100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Minnesota) | Primary |
Bluestone Oral And Maxillofacial Surgery, P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1616 Cloquet Ave, Cloquet, MN 55720 Phone: 218-879-3761 Fax: 218-879-6057 | |
North Country Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 716 14th St, Cloquet, MN 55720 Phone: 218-879-5271 Fax: 218-878-7990 |