| Main Street Dental Clinic Of Blooming Prairie, Pllp | |
|
405 E Main Street Blooming Prairie MN 55917 | |
| (507) 583-2141 | |
| (507) 583-7574 |
| Full Name | Main Street Dental Clinic Of Blooming Prairie, Pllp |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 405 E Main Street, Blooming Prairie, Minnesota |
| Authorized Official Name and Position | John M Flor (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 5075832141 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Dental Clinic Of Blooming Prairie, Pllp 405 E Main Street Blooming Prairie MN 55917 Ph: (507) 583-2141 | Main Street Dental Clinic Of Blooming Prairie, Pllp 405 E Main Street Blooming Prairie MN 55917 Ph: (507) 583-2141 |
| NPI Number | 1518931880 |
|---|---|
| Provider Enumeration Date | 02/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518931880 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1822087 (Minnesota) | Primary |
Main Street Dental Mc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 405 E Main Street, Blooming Prairie, MN 55917 Phone: 507-583-2141 Fax: 507-583-7574 | |
Blooming Prairie Dental Center, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 132 - 2nd Ave Ne, Blooming Prairie, MN 55917 Phone: 507-583-6613 Fax: 507-583-2873 |