Mississippi Headwaters Area Dental Health Center, Inc.

Organization Active NPI Dental Clinic/Center · Halstad, MN

NPI 1669949442 · NPPES record last updated Oct 30, 2018

Key facts

NPI
1669949442
Entity type
Organization (NPI type 2)
Primary specialty
Dental Clinic/Center 261QD0000X
Legal business name
MISSISSIPPI HEADWATERS AREA DENTAL HEALTH CENTER, INC.
Practice address
132 3Rd St W
Halstad, MN 56548-4015
Phone
(218) 456-2238
Fax
(218) 456-2248
NPI assigned
Oct 30, 2018
Organization subpart
Yes
Parent organization (as reported)
MISSISSIPPI HEADWATERS AREA DENTAL HEALTH CENTER

Authorized official

Name
Erica Anne Lundberg, MBA
Title
Director of Operations
Phone
(218) 444-9147

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Corporate family (same tax ID) 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

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

National Provider Directory

Tax ID family
Mississippi Headwaters Area Dental Health Center Inc (4 organizations share this tax ID)
Part of
Mississippi Headwaters Area Dental Health Center Inc

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Yes

Addresses

Primary practice location

132 3Rd St W
Halstad, MN 56548-4015

Mailing address

1405 Anne St NW
Bemidji, MN 56601-5113
Phone (218) 444-9147

Other names

  • Northern Dental Access Center Doing business as

Other providers in Halstad, MN

All providers in Halstad, MN · Dental Clinic/Center in Minnesota

Sources for this page

Verify at the official NPI Registry.