| North Country Dental Service | |
|
1311 Bemidji Ave N Bemidji MN 56601-3811 | |
| (218) 751-1111 | |
| (218) 444-6318 |
| Full Name | North Country Dental Service |
|---|---|
| Speciality | Dentist |
| Location | 1311 Bemidji Ave N, Bemidji, Minnesota |
| Authorized Official Name and Position | John E. Lueth (DENTIST) |
| Authorized Official Contact | 2187511111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Country Dental Service 1311 Bemidji Ave N P.o. Box 1310 Bemidji MN 56601-3811 Ph: (218) 751-1111 | North Country Dental Service 1311 Bemidji Ave N Bemidji MN 56601-3811 Ph: (218) 751-1111 |
| NPI Number | 1225204704 |
|---|---|
| Provider Enumeration Date | 05/05/2008 |
| Last Update Date | 08/17/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225204704 | NPI | - | NPPES |
| 843220100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 9539 (Minnesota) | Primary |
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