Cannon Falls Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CANNON FALLS DENTAL LLC

Doing business as

Cannon Falls Dental

Practice address

411 Main St W
Cannon Falls, MN 55009-2044

Phone

(507) 263-2411

Fax

(507) 263-2413

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Patrick James Prochaska, D.D.S.

Title

Managing Owner

Phone

(507) 263-2411

Specialties & licenses 1

Addresses

Other names 1

• Cannon Falls Dental Doing business as

Locations

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265531685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 MAIN ST W",
            "address_2": "P. O. BOX 17",
            "city": "CANNON FALLS",
            "state": "MN",
            "postal_code": "550092044",
            "telephone_number": "507-263-2411",
            "fax_number": "507-263-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 MAIN ST W",
            "city": "CANNON FALLS",
            "state": "MN",
            "postal_code": "550092044",
            "telephone_number": "507-263-2411",
            "fax_number": "507-263-2413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANNON FALLS DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PROCHASKA",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "MANAGING OWNER",
        "authorized_official_telephone_number": "507-263-2411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cannon Falls Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scott Joseph Benson, MD
• Kerry K Brown, PSY.D.
• Kim Brown, MPT
• Daniel Curtis Callstrom, D.D.S.
• Cannon Falls Al Operations LLC
• Cannon Falls Family Dental
• Cannon Falls Isd #252
• Cannon Falls Medical Center (Mayo Health Systems)
• Cannon Falls Nursing Rehabilitation, LLC (The Gardens at Cannon Falls)
• Cannon Falls Snyder Phcy Inc

• Dentist in Cannon Falls, MN
• Providers in Cannon Falls, MN by specialty
• Dentist 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.