NPI 1124407143

Woodland Dentistry

Organisation Clinic/Center Alexandria, MN

Practice location

Address: 1301 Hawthorne St, Alexandria, MN 56308-2555
Phone: (320) 762-0279
Mailing address: 1301 Hawthorne Street, Alexandria, MN 56308

Authorised official

Name: Tyler Geyen
Title: Dentist
Phone: (320) 762-0279

Registered specialties

Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261Q00000X Licence D13374 (MN)

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Registry record

NPI: 1124407143
Entity type: Organization
NPI issued: 22 May 2015
Record last updated: 22 May 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.