Organization · Type 2 NPI

State of Minnesota - Minnesota Management and Budget

General Practice Dentistry · Montevideo, MN

NPI number 1407662653 Active

Practice location

2190 William Ave
Montevideo, MN 56265-2273

Call (651) 396-6260 Map

Mailing address

5101 Minnehaha Ave Bldg 10
Minneapolis, MN 55417-1647

Specialties and licenses

Taxonomy	Code	License
General Practice Dentistry Primary	1223G0001X	None listed

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Other general practice dentistry providers in Montevideo

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NPI record

NPI: 1407662653
Entity type: Organization (Type 2)
Issued: Dec 3, 2024
Last updated: Dec 3, 2024
Status: Active
Subpart: Yes of State of Minnesota - Minnesota Management and Budget

Other names

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Minnesota Veterans Homes Dental Clinic · doing business as

Authorized official

Simone Renee Hogan
Mdva Chief Operations Director
(612) 505-4110

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1407662653

State of Minnesota - Minnesota Management and Budget's National Provider Identifier is 1407662653, issued on Dec 3, 2024. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Montevideo, MN. The record was last updated on Dec 3, 2024.