Elizabeth Ann Foss, DMD

Individual provider Active NPI General Practice Dentistry · Pine City, MN

NPI 1306579396 · NPPES record last updated Jul 6, 2022

Key facts

NPI
1306579396
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
D14797 (MN)
Practice address
1105 Hillside Ave SW
Pine City, MN 55063-2153
Phone
(320) 336-8927
NPI assigned
Jul 6, 2022
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
D14797MNMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D14797 MN Yes

Addresses

Primary practice location

1105 Hillside Ave SW
Pine City, MN 55063-2153

Mailing address

1105 Hillside Ave SW
Pine City, MN 55063-2153

Other providers in Pine City, MN

All providers in Pine City, MN · General Practice Dentistry in Minnesota

Sources for this page

Verify at the official NPI Registry.