Southern Minnesota Sleep Center, PLLC

Organization Active NPI General Practice Dentistry · Montgomery, MN

NPI 1750165171 · NPPES record last updated Oct 15, 2024

Key facts

NPI
1750165171
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
SOUTHERN MINNESOTA SLEEP CENTER, PLLC
Practice address
110 1St St N
Montgomery, MN 56069-1514
Phone
(920) 316-0002
NPI assigned
Aug 24, 2023
Organization subpart
No

Authorized official

Name
Karisa Bollinger
Title
Marketing Manager
Phone
(507) 317-8039

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240426001557 MN DME Supplier - Oral Surgery - Dentist 1456791250 Practice locations: Montgomery, MN

National Provider Directory

Locations

110 1st St N
Montgomery, MN 56069
Phone (507) 323-5959

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193200000X MULTI-SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

110 1St St N
Montgomery, MN 56069-1514

Mailing address

110 1St St N
Montgomery, MN 56069-1514
Phone (920) 316-0002

Other names

  • Southern Minnesota Sleep Center, PLLC Doing business as

Other providers in Montgomery, MN

All providers in Montgomery, MN · General Practice Dentistry in Minnesota

Sources for this page

Verify at the official NPI Registry.