| The Dentists House Llc | |
|
505 4th St Nw Faribault MN 55021-5032 | |
| (507) 334-7471 | |
| Not Available |
| Full Name | The Dentists House Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 505 4th St Nw, Faribault, Minnesota |
| Authorized Official Name and Position | Mark Lavern Ohlsen (DENTISTS) |
| Authorized Official Contact | 5073347471 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Dentists House Llc 505 4th St Nw Faribault MN 55021-5032 Ph: (507) 334-7471 | The Dentists House Llc 505 4th St Nw Faribault MN 55021-5032 Ph: (507) 334-7471 |
| NPI Number | 1669634812 |
|---|---|
| Provider Enumeration Date | 06/30/2008 |
| Last Update Date | 06/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669634812 | NPI | - | NPPES |
| 273522900 | Other | MN | MEDICAL ASSISTANCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D10296 (Minnesota) | Primary |
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