| Friendly Dental | |
|
1316 Mcmillan St Worthington MN 56187-1646 | |
| (507) 376-5525 | |
| (507) 376-3796 |
| Full Name | Friendly Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1316 Mcmillan St, Worthington, Minnesota |
| Authorized Official Name and Position | Jerry Lee Johnson (PRESIDENT) |
| Authorized Official Contact | 5073765525 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Friendly Dental 1316 Mcmillan St Worthington MN 56187-1646 Ph: (507) 376-5525 | Friendly Dental 1316 Mcmillan St Worthington MN 56187-1646 Ph: (507) 376-5525 |
| NPI Number | 1770672958 |
|---|---|
| Provider Enumeration Date | 10/12/2006 |
| Last Update Date | 03/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770672958 | NPI | - | NPPES |
| 820-6852 | Other | UNITED CONCORDIA | |
| 46483JO | Other | BLUE CROSS BLUE SHIELD | |
| 675-2375 | Other | MN | TAX ID |
| 10185 | Other | FM | DELTA |
| 687623400 | Other | MN | MINNESOTA MEDICAID - OFC. |
| 0964114 | Other | IA | DELTA |
| 10185 | Other | FM | DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 10185 (Minnesota) | Primary |
E.t. Mcniece Dds, P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1027 2nd Ave, Worthington, MN 56187 Phone: 507-372-7339 Fax: 507-372-7330 | |
Midwest Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 507 S Shore Dr, Worthington, MN 56187 Phone: 507-372-2072 Fax: 507-372-2362 | |
Applewhite Dental Partners Of Worthington Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1027 2nd Ave, Worthington, MN 56187 Phone: 507-372-7339 | |
Grant R. Sorensen, Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1029 3rd Ave Ste 1, Worthington, MN 56187 Phone: 507-376-9797 | |
Bruce Wm. Anderson, D.d.s., Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1029 2nd Ave, Worthington, MN 56187 Phone: 507-372-2166 | |
Worthington Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1029 3rd Ave, Worthington, MN 56187 Phone: 507-376-9797 |