Clarissa Family Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

CLARISSA FAMILY DENTAL

Practice address

214 Main St W
Clarissa, MN 56440-4500

Phone

(218) 756-2234

Fax

(218) 756-2427

NPI assigned

Mar 17, 2010

Last updated

Mar 17, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeralyn B Bowie, D.D.S.NPI 1316170301

Title

Owner

Phone

(218) 756-2234

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeralyn B Bowie, DDS

  • Dentist
  • Clarissa, MN
  • NPI 1316170301
  Authorized official Same address or phone

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268784000000",
    "number": "1780908962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 MAIN ST W",
            "address_2": "P. O. BOX 416",
            "city": "CLARISSA",
            "state": "MN",
            "postal_code": "564404500",
            "telephone_number": "218-756-2234",
            "fax_number": "218-756-2427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 MAIN ST W",
            "city": "CLARISSA",
            "state": "MN",
            "postal_code": "564404500",
            "telephone_number": "218-756-2234",
            "fax_number": "218-756-2427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARISSA FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-17",
        "last_updated": "2010-03-17",
        "status": "A",
        "authorized_official_last_name": "BOWIE",
        "authorized_official_first_name": "JERALYN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-756-2234",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeralyn B Bowie, DDS
• Central Todd County Care Center, Inc.
• Clarissa Dental Clinic P.a.
• Dominic Gagnon, D.D.S., P.L.L.C.
• John M Romstad, D.D.S.
• Seip Drug LLC (Seip Drug #14)

• Dental Clinic/Center in Clarissa, MN
• Providers in Clarissa, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; 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.