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701 Highway 10 E Detroit Lakes MN 56501-4219 | |
(218) 847-9214 | |
(218) 847-9215 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 701 Highway 10 E, Detroit Lakes, Minnesota |
Authorized Official Name and Position | Kristine M Riewer (OWNER) |
Authorized Official Contact | 2188479214 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 517 Detroit Lakes MN 56502-0517 Ph: (218) 847-9214 | 701 Highway 10 E Detroit Lakes MN 56501-4219 Ph: (218) 847-9214 |
NPI Number | 1255604781 |
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Provider Enumeration Date | 02/14/2012 |
Last Update Date | 08/15/2012 |
Identifier | Type | State | Issuer |
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1255604781 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | (Minnesota) | Primary |