Mille Lacs Band of Ojibwe Indians

NPI #1104996867 in Onamia, Minnesota

Provider Information

NPI Number: 1104996867
Entity Type: Organization
Organization Name: Mille Lacs Band of Ojibwe Indians
Subpart: Yes (part of a larger organization)
Parent Organization: MILLE LACS BAND OF OJIBWE INDIANS
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Nov 9, 2006
Last Updated: Oct 14, 2021

Practice Location

Address: 18562 MINOBIMAADIZI LOOP
City: Onamia
State: Minnesota
ZIP Code: 56359-2241
Phone: (320) 532-4163

Authorized Official

Name: NICOLE ANDERSON
Title: COMMISSIONER OF HEALTH & HUMAN SERV
Phone: (320) 532-4163

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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