Daniel Walter Iverson, D.D.S.

Individual provider Active NPI General Practice Dentistry · Two Harbors, MN

NPI 1104990902 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104990902
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
8592 (MN)
Practice address
510 1St Ave
Two Harbors, MN 55616-1504
Phone
(218) 834-2011
Fax
(218) 834-6028
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Two Harbors Family Dental, PA General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8592 MN Yes

Addresses

Primary practice location

510 1St Ave
Two Harbors, MN 55616-1504

Mailing address

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

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.