Mahtomedi Family Dental

LBN: Mahtomedi Family Dental
Mahtomedi Family Dental is an health care organization with primary practice located at 814 Mahtomedi Ave , Mahtomedi MN 55115-1730. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Mahtomedi Family Dental can be contacted via phone (651) 426-0011, or through Welle, Brian via phone (651) 426-0011.

Contact Information

Primary practice address
814 Mahtomedi Ave Mahtomedi MN 55115-1730
Phone: (651) 426-0011
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Welle, Brian
Phone: (651) 426-0011

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D7721 Minnesota

Profile Details

NPI number 1720415896
LBN Legal business name Mahtomedi Family Dental
DBA Doing business as
Authorized official Welle, Brian
Entity Organization
Organization subpart 1 No
Enumeration date Oct 3rd, 2013
Last updated Oct 3rd, 2013 - about 13 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 1720415896 NPPES
Minnesota MEDICAID 1811212624

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