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2190 William Ave Montevideo MN 56265-2273 | |
| (651) 396-6260 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2190 William Ave, Montevideo, Minnesota |
| Authorized Official Name and Position | Simone Renee Hogan (MDVA CHIEF OPERATIONS DIRECTOR) |
| Authorized Official Contact | 6125054110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5101 Minnehaha Ave Bldg 10 Minneapolis MN 55417-1647 Ph: () - | 2190 William Ave Montevideo MN 56265-2273 Ph: (651) 396-6260 |
| NPI Number | 1407662653 |
|---|---|
| Provider Enumeration Date | 12/03/2024 |
| Last Update Date | 12/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407662653 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Montevideo Family Dentistry Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 629 Legion Dr Ste 2, Montevideo, MN 56265 Phone: 320-269-6416 Fax: 320-269-8136 | |
West Central Smiles Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 123 1/2 N. First St., Montevideo, MN 56265 Phone: 320-235-3102 |