| Main Street Dental Clinic Of Mankato, Pllp | |
|
287 St Andrews Drive 100 Mankato MN 56001 | |
| (507) 720-0250 | |
| Not Available |
| Full Name | Main Street Dental Clinic Of Mankato, Pllp |
|---|---|
| Speciality | Dentist |
| Location | 287 St Andrews Drive, Mankato, Minnesota |
| Authorized Official Name and Position | Chad Michael Hanson (CFO) |
| 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 Mankato, Pllp 287 St Andrews Drive 100 Mankato MN 56001-8584 Ph: (507) 720-0250 | Main Street Dental Clinic Of Mankato, Pllp 287 St Andrews Drive 100 Mankato MN 56001 Ph: (507) 720-0250 |
| NPI Number | 1285032243 |
|---|---|
| Provider Enumeration Date | 12/08/2014 |
| Last Update Date | 12/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285032243 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12942 (Minnesota) | Primary |
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