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511 Elm St Farmington MN 55024-1126 | |
| (952) 303-7028 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 511 Elm St, Farmington, Minnesota |
| Authorized Official Name and Position | John Gulon (PRESIDENT) |
| Authorized Official Contact | 6516330500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2200 County Road C W Suite 2210 Roseville MN 55113-2550 Ph: (651) 633-0500 | 511 Elm St Farmington MN 55024-1126 Ph: (952) 303-7028 |
| NPI Number | 1962760462 |
|---|---|
| Provider Enumeration Date | 05/03/2012 |
| Last Update Date | 10/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962760462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Immanuel Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 321 Third Street, Farmington, MN 55024 Phone: 651-463-2880 Fax: 651-463-2840 | |
Dental Health Center, Dds, Pa Dental Clinic Medicare: Medicare Enrolled Practice Location: 19645 Pilot Knob Rd, Farmington, MN 55024 Phone: 651-463-2300 Fax: 651-463-2118 | |