Central Mn Pediatric Dentists Pa

LBN: Central Mn Pediatric Dentists Pa
Central Mn Pediatric Dentists Pa is an health care organization with primary practice located at 1900 Centracare Circle Ste 0350, St Cloud MN 56303-5000. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. Central Mn Pediatric Dentists Pa can be contacted via phone (320) 253-0272, or through Wenner, Joseph Hall via phone (320) 253-0272.

Contact Information

Primary practice address
1900 Centracare Circle Ste 0350 St Cloud MN 56303-5000
Phone: (320) 253-0272
Fax: (320) 251-2661
Website:
Map and Directions
Authorized official contact:
Name: Wenner, Joseph Hall Doctor of Dental Surgery (DDS)
Phone: (320) 253-0272

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X

Profile Details

NPI number 1144267063
LBN Legal business name Central Mn Pediatric Dentists Pa
DBA Doing business as
Authorized official Wenner, Joseph Hall Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date May 31st, 2006
Last updated Jun 18th, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144267063 NPPES
Minnesota MEDICAID 678350300
Minnesota Other 55520WE

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