Great River Dentistry Of Bemidji, P.A.

LBN: Great River Dentistry Of Bemidji, P.A.
Great River Dentistry Of Bemidji, P.A. is an health care organization with primary practice located at 3622 Moberg Dr Nw , Bemidji MN 56601-5644. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Great River Dentistry Of Bemidji, P.A. can be contacted via phone (218) 751-4216, or through Williams, Douglas R via phone (218) 751-4216.

Contact Information

Primary practice address
3622 Moberg Dr Nw Bemidji MN 56601-5644
Phone: (218) 751-4216
Fax: (218) 444-6057
Website:
Map and Directions
Authorized official contact:
Name: Williams, Douglas R Doctor of Dental Surgery (DDS)
Phone: (218) 751-4216

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X

Profile Details

NPI number 1821260654
LBN Legal business name Great River Dentistry Of Bemidji, P.A.
DBA Doing business as
Authorized official Williams, Douglas R Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 1st, 2008
Last updated Jun 11th, 2008 - about 18 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 1821260654 NPPES
Minnesota MEDICAID 172820200

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