Fairmont Dental Professionals LLC
Organization Active NPI Dentist · Fairmont, MN
NPI 1730850306 · NPPES record last updated Sep 23, 2021
Key facts
- NPI
- 1730850306
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- Legal business name
- FAIRMONT DENTAL PROFESSIONALS LLC
- Practice address
- 1950 Center Creek Dr Ste 200
Fairmont, MN 56031-3430 - Phone
- (507) 238-2812
- NPI assigned
- Sep 23, 2021
- Organization subpart
- No
Authorized official
- Name
- Mitch Weiland
- Title
- Assistant Controller
- Phone
- (608) 343-0818
Practitioners 2
-
Nathan Luitjens, DDS
-
Kurt Daniel Erickson, DDS
National Provider Directory
Locations
1950 Center Creek Dr
Ste 200
Fairmont, MN 56031
Phone (507) 238-2812
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | Yes |
Addresses
Primary practice location
1950 Center Creek Dr Ste 200
Fairmont, MN 56031-3430
Mailing address
8025 Excelsior Dr
Madison, WI 53717-1900
Phone (608) 343-0818
Other providers in Fairmont, MN
- Lisa Marie Ertman
- Luke K Espelund
- Eunoia Family Resource Center PA
- Alisa Sarah Eytcheson
- Fairmont Chiropractic & Acupuncture Healthcare, LTD
- Fairmont Family Dentistry, PA
- Fairmont Orthopedics & Sports Medicine P a
- Fairmont Orthopedics & Sports Medicine, PA
- Fairmont Orthopedics & Sports Medicine, PA
- Samantha Augusta Farnum
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.