State of Minnesota Minnesota Management and Budget

NPI #1568168987 in Luverne, Minnesota

Provider Information

NPI Number
1568168987
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 MANAGE
Primary Specialty
Dentist - General Practice
Enumeration Date
Feb 7, 2023
Last Updated
Dec 3, 2024

Practice Location

Address
1300 NORTH KNISS AVE.
ZIP Code
56156-1006
Phone
(507) 283-6200

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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