Mississippi Headwaters Area Dental Health Center, Inc.

NPI #1225811102 in Bagley, Minnesota

Provider Information

NPI Number: 1225811102
Entity Type: Organization
Organization Name: Mississippi Headwaters Area Dental Health Center, Inc.
Subpart: Yes (part of a larger organization)
Parent Organization: MISSISSIPPI HEADWATERS AREA DENTAL HEALTH CENTER
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Aug 15, 2023
Last Updated: Aug 15, 2023

Practice Location

Address: 13 MAIN AVE N
City: Bagley
State: Minnesota
ZIP Code: 56621-8315
Phone: (218) 694-6571

Authorized Official

Name: ERICA ANNE LUNDBERG, MBA
Title: DIRECTOR OF FINANCE AND OPERATIONS
Phone: (218) 444-9147

Specialties & Taxonomy Codes

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

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