East Side Family Dental Clinic

LBN: West Side Community Health Services, Inc.
East Side Family Dental Clinic is an health care organization with primary practice located at 895 E. 7Th St , St Paul MN 55106-3852. The organization recently has only one registered license in Ambulatory Health Care Facilities / Dental, which is considered as the primary health care specialty. West Side Community Health Services, Inc. can be contacted via phone (651) 772-9757, or through Moore, Reuben via phone (651) 602-7500.

Contact Information

Primary practice address
895 E. 7Th St St Paul MN 55106-3852
Fax: (651) 772-9959
Website:
Authorized official contact:
Name: Moore, Reuben

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Dental 261QD0000X 302133 Minnesota

Profile Details

NPI number 1912058058
LBN Legal business name West Side Community Health Services, Inc.
DBA Doing business as East Side Family Dental Clinic
Authorized official Moore, Reuben
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 16th, 2007
Last updated May 15th, 2024 - about 2 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 1912058058 NPPES
Minnesota MEDICAID 955353300

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