West Side Dental Clinic

LBN: West Side Community Health Services, Inc.
West Side Dental Clinic is an health care organization with primary practice located at 478 Robert St S , Saint Paul MN 55107-2236. The organization recently has only one registered license in Ambulatory Health Care Facilities / Dental, which is considered as the primary health care specialty. West Side Community Health Services, Inc. can be contacted via phone (651) 602-7575, or through Moore, Reuben via phone (651) 602-7500.

Contact Information

Primary practice address
478 Robert St S Saint Paul MN 55107-2236
Fax: (651) 602-7518
Website:
Authorized official contact:
Name: Moore, Reuben

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Dental 261QD0000X 302133 Minnesota

Profile Details

NPI number 1417007436
LBN Legal business name West Side Community Health Services, Inc.
DBA Doing business as West Side Dental Clinic
Authorized official Moore, Reuben
Entity Organization
Organization subpart 1 No
Enumeration date Jan 11th, 2007
Last updated May 15th, 2024 - about 6 months 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 1417007436 NPPES
Minnesota MEDICAID 250711100

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