| Virginia/gilbert Family Dental | |
|
12 North Broadway Gilbert MN 55741 | |
| (218) 741-5357 | |
| (218) 741-5455 |
| Full Name | Virginia/gilbert Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12 North Broadway, Gilbert, Minnesota |
| Authorized Official Name and Position | Mark A. Erickson (PRESIDENT) |
| Authorized Official Contact | 2187415357 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Virginia/gilbert Family Dental P.o. Box 608 Virginia/gilbert Family Dental Gilbert MN 55741 Ph: (218) 741-5357 | Virginia/gilbert Family Dental 12 North Broadway Gilbert MN 55741 Ph: (218) 741-5357 |
| NPI Number | 1790012847 |
|---|---|
| Provider Enumeration Date | 11/11/2009 |
| Last Update Date | 11/11/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790012847 | NPI | - | NPPES |
| 10580600700 | Other | STATE OF MINNESOTA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Erickson,holbeck.and Zupancic Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 12 North Broadway, Gilbert, MN 55741 Phone: 218-741-5357 Fax: 218-741-5455 |