Organization · Type 2 NPI

State of Minnesota Minnesota Management and Budget

General Practice Dentistry · Fergus Falls, MN

NPI number 1447956875 Active

Practice location

1821 N. Park Street
Fergus Falls, MN 56537-1247

Call (218) 736-0400 Map

Fax (612) 548-5964

Mailing address

5101 Minnehaha Ave. S
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 Fergus Falls

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NPI record

NPI: 1447956875
Entity type: Organization (Type 2)
Issued: Feb 7, 2023
Last updated: Dec 3, 2024
Status: Active
Subpart: Yes of State of Minnesota Minnesota Manage

Other names

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Minnesota Veterans Homes Dental Clinic · doing business as
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 1447956875

State of Minnesota Minnesota Management and Budget's National Provider Identifier is 1447956875, issued on Feb 7, 2023. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Fergus Falls, MN. The record was last updated on Dec 3, 2024.