| Southwest Dental Care | |
|
107 12th St Sw Ste 2 Forest Lake MN 55025-1467 | |
| (612) 261-4998 | |
| Not Available |
| Full Name | Southwest Dental Care |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 107 12th St Sw Ste 2, Forest Lake, Minnesota |
| Authorized Official Name and Position | Jessica Britt (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175408426 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Dental Care 107 12th St Sw Ste 2 Forest Lake MN 55025-1467 Ph: (651) 964-2013 | Southwest Dental Care 107 12th St Sw Ste 2 Forest Lake MN 55025-1467 Ph: (612) 261-4998 |
| NPI Number | 1619451192 |
|---|---|
| Provider Enumeration Date | 09/20/2018 |
| Last Update Date | 12/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619451192 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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