| Mora Dental Center | |
|
547 Union St S Mora MN 55051-1817 | |
| (320) 679-2147 | |
| (320) 679-2101 |
| Full Name | Mora Dental Center |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 547 Union St S, Mora, Minnesota |
| Authorized Official Name and Position | Reny Chacko (DENTIST) |
| Authorized Official Contact | 3206792147 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mora Dental Center 547 Union St S Mora MN 55051-1817 Ph: (320) 679-2147 | Mora Dental Center 547 Union St S Mora MN 55051-1817 Ph: (320) 679-2147 |
| NPI Number | 1700065687 |
|---|---|
| Provider Enumeration Date | 10/29/2007 |
| Last Update Date | 10/29/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700065687 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 11844 (Minnesota) | Primary |
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Mora Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 547 Union St S, Mora, MN 55051 Phone: 320-679-2147 Fax: 320-679-2101 | |
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