State of Minnesota - Minnesota Management and Budget

NPI #1144036393 in Bemidji, Minnesota

Provider Information

NPI Number
1144036393
Entity Type
Organization
Organization Name
State of Minnesota - Minnesota Management and Budget
Subpart
Yes (part of a larger organization)
Parent Organization
STATE OF MINNESOTA - MINNESOTA MANAGEMENT AND BUDGET
Primary Specialty
Dentist - General Practice
Enumeration Date
Dec 3, 2024
Last Updated
Dec 3, 2024

Practice Location

Address
920 ANNE ST NW
ZIP Code
56601-5104
Phone
(651) 396-6260

Authorized Official

Name
SIMONE RENEE HOGAN
Title
MDVA HEALTHCARE OPERATIONS DIRECTOR
Phone
(612) 505-4110

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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