Two Harbors Family Dental, PA

Organization Active NPI General Practice Dentistry · Two Harbors, MN

NPI 1104379635 · NPPES record last updated Aug 2, 2016

Key facts

NPI
1104379635
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
D12388 (MN)
Legal business name
TWO HARBORS FAMILY DENTAL, PA
Practice address
510 1St Ave
Two Harbors, MN 55616-1504
Phone
(218) 834-2011
Fax
(218) 834-6028
NPI assigned
Aug 2, 2016
Organization subpart
No

Authorized official

Name
Robert Benjamin Yankovich, DDS NPI 1225221039
Title
President
Phone
(218) 409-2400

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

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

National Provider Directory

Locations

510 1st Ave
Two Harbors, MN 55616
Phone (218) 340-7467

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X D12388 MN Yes

Addresses

Primary practice location

510 1St Ave
Two Harbors, MN 55616-1504

Mailing address

510 1St Ave
PO Box 59
Two Harbors, MN 55616-1504
Phone (218) 834-2011

Other names

  • Two Harbors Family Dental Doing business as

Other providers in Two Harbors, MN

All providers in Two Harbors, MN · General Practice Dentistry in Minnesota

Sources for this page

Verify at the official NPI Registry.