| Great River Endodontics, Pa | |
|
1100 19th Ave Sw Willmar MN 56201-5006 | |
| (320) 259-5078 | |
| (320) 259-5078 |
| Full Name | Great River Endodontics, Pa |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 1100 19th Ave Sw, Willmar, Minnesota |
| Authorized Official Name and Position | Thomas Andrew Karn (OWNER/PRESIDENT) |
| Authorized Official Contact | 3202595078 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great River Endodontics, Pa 622 Roosevelt Rd Ste 180 Saint Cloud MN 56301-6361 Ph: (320) 259-5078 | Great River Endodontics, Pa 1100 19th Ave Sw Willmar MN 56201-5006 Ph: (320) 259-5078 |
| NPI Number | 1144583527 |
|---|---|
| Provider Enumeration Date | 06/20/2012 |
| Last Update Date | 06/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144583527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 11880 (Minnesota) | Primary |
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