Pine River Dental Center LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

8357 Issued in MN

Legal business name

PINE RIVER DENTAL CENTER LLC

Practice address

203 Park Ave W
Pine River, MN 56474-4495

Phone

(218) 587-4437

NPI assigned

Jun 5, 2008

Organization subpart

No

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

Authorized official

Name

John M Collier, D.D.S

Title

Owner

Phone

(218) 587-4437

Specialties & licenses 3

Addresses

Tax ID family

Pine River Dental Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Pine River Dental Center LLC

  • General Practice Dentistry
  • Pine River, MN
  • NPI 1265845937
  NPD tax ID

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225238400000",
    "number": "1891954830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650",
            "city": "PINE RIVER",
            "state": "MN",
            "postal_code": "564740650",
            "telephone_number": "218-587-4437",
            "fax_number": "218-587-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 PARK AVE W",
            "city": "PINE RIVER",
            "state": "MN",
            "postal_code": "564744495",
            "telephone_number": "218-587-4437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE RIVER DENTAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2008-10-29",
        "status": "A",
        "authorized_official_last_name": "COLLIER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-587-4437",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "7903",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "D7197",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "8357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael S Marvin, O.D.
• Northwoods Dna, Inc. (Brookside)
• Taylor Anne Ott, PHARMD
• Pine River Dental Arts, P.C.
• Pine River Dental Center LLC
• Pine River Eye Center, Inc. (Associates In Eyecare)
• Annette M Pohl, LPT
• Jaime Lyn Preble, DDS
• Ronald Lee Prouty, DC
• Amalia Richards, CLC

• Dental Clinic/Center in Pine River, MN
• Providers in Pine River, 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 Oct 29, 2008; 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.