Fergus Falls Dental Group

LBN: Fergus Falls Dental Group
Fergus Falls Dental Group is an health care organization with primary practice located at 1121 Pebble Lake Rd , Fergus Falls MN 56537. The organization recently has only one registered license in Dental Providers / Dental Public Health, which is considered as the primary health care specialty. Fergus Falls Dental Group can be contacted via phone (218) 739-7254, or through Kornrumpf, Rod L. via phone (651) 431-5003.

Contact Information

Primary practice address
1121 Pebble Lake Rd Fergus Falls MN 56537
Phone: (218) 739-7254
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Kornrumpf, Rod L.
Phone: (651) 431-5003

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Public Health 1223D0001X

Profile Details

NPI number 1205991866
LBN Legal business name Fergus Falls Dental Group
DBA Doing business as
Authorized official Kornrumpf, Rod L.
Entity Organization
Organization subpart 1 No
Enumeration date Dec 26th, 2006
Last updated Feb 27th, 2009 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205991866 NPPES
Minnesota MEDICAID 102325000

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