NPI 1548320112

Msctc Community Dental Clinic

Organisation Public Health Dentistry Moorhead, MN

Practice location

Address: 1900 28th Ave S, Moorhead, MN 56560-4830
Phone: (218) 299-6819
Fax: (218) 299-6532
Mailing address: 1900 28th Avenue South, Moorhead, MN 56560

Authorised official

Name: Thomas L Boe
Title: Director Dental Department
Phone: (218) 299-6819

Registered specialties

Public Health Dentistry Primary

Dental Providers Taxonomy 1223D0001X

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Registry record

NPI: 1548320112
Entity type: Organization
NPI issued: 12 Dec 2006
Record last updated: 22 Aug 2020

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.