Olivia Family Dental | |
907 W Lincoln Ave Olivia MN 56277-4215 | |
(320) 523-1441 | |
(320) 523-1441 |
Full Name | Olivia Family Dental |
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Speciality | Dentist |
Location | 907 W Lincoln Ave, Olivia, Minnesota |
Authorized Official Name and Position | Mark Joseph Moorse (PRESIDENT) |
Authorized Official Contact | 3205231441 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Olivia Family Dental 907 W Lincoln Ave Olivia MN 56277-4215 Ph: (320) 523-1441 | Olivia Family Dental 907 W Lincoln Ave Olivia MN 56277-4215 Ph: (320) 523-1441 |
NPI Number | 1073594891 |
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Provider Enumeration Date | 11/09/2005 |
Last Update Date | 11/24/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073594891 | NPI | - | NPPES |
120523400 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | D11030 (Minnesota) | Primary |