| Mississippi Headwaters Area Dental Health Center, Inc. | |
|
206 Pleasant Ave S Park Rapids MN 56470-1417 | |
| (218) 732-4436 | |
| Not Available |
| Full Name | Mississippi Headwaters Area Dental Health Center, Inc. |
|---|---|
| Speciality | Dentist - Dental Public Health |
| Location | 206 Pleasant Ave S, Park Rapids, Minnesota |
| Authorized Official Name and Position | Erica Anne Lundberg (DIRECTOR OF FINANCE AND OPERATIONS) |
| Authorized Official Contact | 2184449147 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mississippi Headwaters Area Dental Health Center, Inc. 1405 Anne St Nw Bemidji MN 56601-5113 Ph: (218) 444-9147 | Mississippi Headwaters Area Dental Health Center, Inc. 206 Pleasant Ave S Park Rapids MN 56470-1417 Ph: (218) 732-4436 |
| NPI Number | 1457101974 |
|---|---|
| Provider Enumeration Date | 03/26/2024 |
| Last Update Date | 03/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457101974 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | (* (Not Available)) | Primary |
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