| Greenhaven Family Dental | |
|
13495 Elder Dr Suite 100 Baxter MN 56425-8763 | |
| (218) 454-0523 | |
| (218) 454-0524 |
| Full Name | Greenhaven Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 13495 Elder Dr, Baxter, Minnesota |
| Authorized Official Name and Position | Clinton L Roberts (OWNER) |
| Authorized Official Contact | 2184540523 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenhaven Family Dental 13495 Elder Dr Suite 100 Baxter MN 56425-8763 Ph: (218) 454-0523 | Greenhaven Family Dental 13495 Elder Dr Suite 100 Baxter MN 56425-8763 Ph: (218) 454-0523 |
| NPI Number | 1508125584 |
|---|---|
| Provider Enumeration Date | 05/10/2012 |
| Last Update Date | 05/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508125584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D10518 (Minnesota) | Primary |
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