| Range Family Dental Llc | |
|
302 Chestnut St Suite 200 Virginia MN 55792-2541 | |
| (218) 741-0089 | |
| Not Available |
| Full Name | Range Family Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 302 Chestnut St, Virginia, Minnesota |
| Authorized Official Name and Position | Jason Olai Berg (OWNER) |
| Authorized Official Contact | 2187410089 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Range Family Dental Llc 302 Chestnut St Suite 200 Virginia MN 55792-2541 Ph: (218) 741-0089 | Range Family Dental Llc 302 Chestnut St Suite 200 Virginia MN 55792-2541 Ph: (218) 741-0089 |
| NPI Number | 1104218239 |
|---|---|
| Provider Enumeration Date | 02/26/2015 |
| Last Update Date | 02/26/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104218239 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D12816 (Minnesota) | Primary |
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