Fairmont Dental Professionals LLC

NPI #1730850306 in Fairmont, Minnesota

Provider Information

NPI Number: 1730850306
Entity Type: Organization
Organization Name: Fairmont Dental Professionals LLC
Primary Specialty: Dentist
Enumeration Date: Sep 23, 2021
Last Updated: Sep 23, 2021

Practice Location

Address: 1950 CENTER CREEK DR STE 200
City: Fairmont
State: Minnesota
ZIP Code: 56031-3430
Phone: (507) 238-2812

Authorized Official

Name: MITCH WEILAND
Title: ASSISTANT CONTROLLER
Phone: (608) 343-0818

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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