| Mankato Family Dental, P.a. | |
|
151 St Andrews Ct Ste 1120 Mankato MN 56001 | |
| (507) 345-4259 | |
| (507) 345-4460 |
| Full Name | Mankato Family Dental, P.a. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 151 St Andrews Ct Ste 1120, Mankato, Minnesota |
| Authorized Official Name and Position | Christopher Kelly Meehan (DDS/OWNER) |
| Authorized Official Contact | 5073454259 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mankato Family Dental, P.a. 151 St Andrews Ct Ste 1120 Mankato MN 56001 Ph: (507) 345-4259 | Mankato Family Dental, P.a. 151 St Andrews Ct Ste 1120 Mankato MN 56001 Ph: (507) 345-4259 |
| NPI Number | 1912013640 |
|---|---|
| Provider Enumeration Date | 08/23/2006 |
| Last Update Date | 05/03/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912013640 | NPI | - | NPPES |
| 1770572877 | Other | MN | OTHER PROVIDER UNDER CORP |
| 1285610022 | Other | MN | INDIVIDUAL UNDER CORPORAT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 10009 (Minnesota) | Primary |
| 1223G0001X | Dentist - General Practice | 12148 (Minnesota) | Secondary |
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