Organization · Type 2 NPI

Mississippi Headwaters Area Dental Health Center, Inc.

Dental Clinic/Center · Halstad, MN

NPI number 1669949442 Active

Practice location

132 3rd St W
Halstad, MN 56548-4015

Call (218) 456-2238 Map

Fax (218) 456-2248

Mailing address

1405 Anne St NW
Bemidji, MN 56601-5113

Specialties and licenses

Taxonomy	Code	License
Dental Clinic/Center Primary	261QD0000X	None listed

Dental Clinic/Center: Definition to come...

NPI record

NPI: 1669949442
Entity type: Organization (Type 2)
Issued: Oct 30, 2018
Last updated: Oct 30, 2018
Status: Active
Subpart: Yes of Mississippi Headwaters Area Dental Health Center

Other names

Northern Dental Access Center · doing business as

Authorized official

Erica Anne Lundberg, MBA
Director of Operations
(218) 444-9147

Verify this record

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 1669949442

Mississippi Headwaters Area Dental Health Center, Inc.'s National Provider Identifier is 1669949442, issued on Oct 30, 2018. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Halstad, MN. The record was last updated on Oct 30, 2018.