| Root River Dental, Pa | |
|
100 2nd St Se Stewartville MN 55976-1288 | |
| (507) 533-7735 | |
| (507) 533-8852 |
| Full Name | Root River Dental, Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 100 2nd St Se, Stewartville, Minnesota |
| Authorized Official Name and Position | Zachary J Lechner (OWNER/SHAREHOLDER) |
| Authorized Official Contact | 3204930424 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Root River Dental, Pa Po Box 8 Stewartville MN 55976-0008 Ph: (507) 533-7735 | Root River Dental, Pa 100 2nd St Se Stewartville MN 55976-1288 Ph: (507) 533-7735 |
| NPI Number | 1720484496 |
|---|---|
| Provider Enumeration Date | 11/07/2014 |
| Last Update Date | 11/07/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720484496 | NPI | - | NPPES |
| 837637000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D45964 (Minnesota) | Primary |
Stewartville Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 1st Ave Ne, Suite #1, Stewartville, MN 55976 Phone: 507-533-4719 |