Mississippi Headwaters Area Dental Health Center, Inc.

NPI #1669949442 in Halstad, Minnesota

Provider Information

NPI Number: 1669949442
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: Oct 30, 2018
Last Updated: Oct 30, 2018

Practice Location

Address: 132 3RD ST W
City: Halstad
State: Minnesota
ZIP Code: 56548-4015
Phone: (218) 456-2238

Authorized Official

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

Specialties & Taxonomy Codes

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

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