| Moorse Dental Psc | |
|
907 W Lincoln Ave Olivia MN 56277-4215 | |
| (320) 523-1441 | |
| (320) 523-1441 |
| Full Name | Moorse Dental Psc |
|---|---|
| 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 |
|---|---|
| Moorse Dental Psc 907 W Lincoln Ave Olivia MN 56277-4215 Ph: (320) 523-1441 | Moorse Dental Psc 907 W Lincoln Ave Olivia MN 56277-4215 Ph: (320) 523-1441 |
| NPI Number | 1073594891 |
|---|---|
| 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 |