Downtown Dental Care PA

Organization Active NPI General Practice Dentistry · Moose Lake, MN

NPI 1073674529 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1073674529
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
DOWNTOWN DENTAL CARE PA
Practice address
304 Elm Ave
Moose Lake, MN 55767
Phone
(218) 485-4455
Fax
(218) 485-0227
NPI assigned
Dec 12, 2006
Organization subpart
No

Authorized official

Name
Dr. Kurt David Stodola, DDS
Title
Doctor Vice President
Phone
(218) 485-4455

Practitioners 2

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

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193200000X MULTI-SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

304 Elm Ave
Moose Lake, MN 55767

Mailing address

PO Box 587
304 Elm Ave
Moose Lake, MN 55767
Phone (218) 485-4455

Other providers in Moose Lake, MN

All providers in Moose Lake, MN · General Practice Dentistry in Minnesota

Sources for this page

Verify at the official NPI Registry.