| John D. Nydahl, Dds, P. A. | |
|
1011 2nd St N Ste 101 Saint Cloud MN 56303-3237 | |
| (320) 253-0744 | |
| (320) 253-9930 |
| Full Name | John D. Nydahl, Dds, P. A. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1011 2nd St N Ste 101, Saint Cloud, Minnesota |
| Authorized Official Name and Position | John D. Nydahl (PRESIDENT) |
| Authorized Official Contact | 3202530744 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John D. Nydahl, Dds, P. A. 1011 2nd St N Ste 101 Saint Cloud MN 56303-3237 Ph: (320) 253-0744 | John D. Nydahl, Dds, P. A. 1011 2nd St N Ste 101 Saint Cloud MN 56303-3237 Ph: (320) 253-0744 |
| NPI Number | 1174547855 |
|---|---|
| Provider Enumeration Date | 07/27/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174547855 | NPI | - | NPPES |
| 55162NY | Other | MN | BLUE CROSS BLUE SHIELD |
| D8204 | Other | MN | DELTA DENTAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D8204 (Minnesota) | Primary |
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