Lone Oak Family Dentistry
Organization Active NPI General Practice Dentistry · Warren, MN
NPI 1053739698 · NPPES record last updated Apr 1, 2014
Key facts
- NPI
- 1053739698
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D12024 (MN)
- Legal business name
- LONE OAK FAMILY DENTISTRY
- Practice address
- 205 W Johnson Ave
Ste. 3
Warren, MN 56762-1118 - Phone
- (218) 745-4601
- Fax
- (218) 745-4600
- NPI assigned
- Apr 1, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Travis Ammen Hanel
- Title
- Dentist
- Phone
- (218) 745-4601
Corporate family (same tax ID) 1
Practitioners 1
-
Travis Hanel, DDS
National Provider Directory
- Tax ID family
- Kittson Dental Clinic PA
Locations
205 W Johnson Ave
Ste 3
Warren, MN 56762
Phone (218) 745-4601
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | D12024 | MN | Yes |
Addresses
Primary practice location
205 W Johnson Ave
Ste. 3
Warren, MN 56762-1118
Mailing address
205 W Johnson Ave
Ste. 3
Warren, MN 56762-1118
Phone (218) 745-4601
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 473990600 | Medicaid | MN |
Other providers in Warren, MN
- Travis Hanel
- Jeremy James Houser
- Rachel M Johnston
- Shelby Knott
- Francis Noel Leblanc
- Lone Oak Family Dentistry
- Bailey Jo Marcotte
- Marshall County Social Services
- Midwest Regenerative Medicine Center PC
- North Star Manor
All providers in Warren, MN · General Practice Dentistry in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.