Downtown Dental Care PA

Primary specialty

General Practice DentistryTaxonomy code 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

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kurt David Stodola, DDSNPI 1982630737

Title

Doctor Vice President

Phone

(218) 485-4455

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kurt David Stodola, DDS

  • Dentist
  • Moose Lake, MN
  • NPI 1982630737
  NPD (past) Authorized official
• James Clinton Hubred, DDS

  • Dentist
  • Moose Lake, MN
  • NPI 1124055330
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073674529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 587",
            "address_2": "304 ELM AVE",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "55767",
            "telephone_number": "218-485-4455",
            "fax_number": "218-485-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 ELM AVE",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "55767",
            "telephone_number": "218-485-4455",
            "fax_number": "218-485-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOWNTOWN DENTAL CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STODOLA",
        "authorized_official_first_name": "KURT",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "DOCTOR VICE PRESIDENT",
        "authorized_official_telephone_number": "218-485-4455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darci Kay Dahl, PTA
• Kimberly Mary Davidson, R.N
• Debbie Davis, LPCC
• Paul R. Dewey, M.D.
• Kathryn Dobbs, M.D.
• Dr. Joseph J. Jamros Optometry, LTD.
• Steffany Drilling, MT
• Tanya Eiffler, DNP, APRN, FNP-C
• Essentia Health Moose Lake
• Essentia Health Moose Lake (Essentia Health Moose Lake Clinic)

• General Practice Dentistry in Moose Lake, MN
• Providers in Moose Lake, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.