Kittson Dental Clinic PA

NPI #1144303256 in Hallock, Minnesota

Provider Information

NPI Number: 1144303256
Entity Type: Organization
Organization Name: Kittson Dental Clinic PA
Primary Specialty: Dentist
Enumeration Date: Oct 23, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1010 SOUTH BIRCH
City: Hallock
State: Minnesota
ZIP Code: 56728
Phone: (218) 843-3343

Authorized Official

Name: DR. TRAVIS AMMEN HANEL, DDS
Title: OWNER ONLY SHAREHOLDER
Phone: (218) 843-3343

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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