Moorse Dental PSC

Primary specialty

DentistTaxonomy code 122300000X

License

D11030 Issued in MN

Legal business name

MOORSE DENTAL PSC

Practice address

907 W Lincoln Ave
Olivia, MN 56277-4215

Phone

(320) 523-1441

Fax

(320) 523-1441

NPI assigned

Nov 9, 2005

Organization subpart

No

Name

Mark Joseph Moorse, DDSNPI 1043548340

Title

President

Phone

(320) 523-1441

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Moorse, DDS

  • General Practice Dentistry
  • Olivia, MN
  • NPI 1043548340
  NPD (past) Authorized official

Locations

• Olivia Family Dental Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 24, 2009.

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259020800000",
    "number": "1073594891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 W LINCOLN AVE",
            "city": "OLIVIA",
            "state": "MN",
            "postal_code": "562774215",
            "telephone_number": "320-523-1441",
            "fax_number": "320-523-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 W LINCOLN AVE",
            "city": "OLIVIA",
            "state": "MN",
            "postal_code": "562774215",
            "telephone_number": "320-523-1441",
            "fax_number": "320-523-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORSE DENTAL PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2009-11-24",
        "status": "A",
        "authorized_official_last_name": "MOORSE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "320-523-1441",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "D11030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120523400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olivia Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jason Chigoro Lee Mabee
• Carin Marie Martinson, M.D.
• Melissa Ann Marvin
• Theresa McNamara, PT
• Joseph Montanaro Jr., M.D.
• Mark Moorse, DDS
• Bruce B Neumann, DPM
• Olivia Ambulance Service, Inc.
• Olivia Drug Company
• Olivia Health and Rehab LLC

• All providers in Olivia, MN
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.