| Midwest Dental - Chisago City | |
|
29663 Gateway Ave Chisago City MN 55013-0339 | |
| (651) 257-3639 | |
| Not Available |
| Full Name | Midwest Dental - Chisago City |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 29663 Gateway Ave, Chisago City, Minnesota |
| Authorized Official Name and Position | Jeffrey Moos (CEO) |
| Authorized Official Contact | 7159265050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Dental - Chisago City 29663 Gateway Ave Chisago City MN 55013-0339 Ph: (651) 257-3639 | Midwest Dental - Chisago City 29663 Gateway Ave Chisago City MN 55013-0339 Ph: (651) 257-3639 |
| NPI Number | 1043589484 |
|---|---|
| Provider Enumeration Date | 12/14/2011 |
| Last Update Date | 12/14/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043589484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Shipp Dental Care, Ltd. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11721 Stinson Ave, Chisago City, MN 55013 Phone: 651-257-2921 Fax: 651-257-2921 |