Range Family Dental Llc

NPI 1104218239 - Dentist - 122300000X

NPI Details
NPI 1104218239
Enumeration Date 02/26/2015
Last Updated 02/26/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name JASON OLAI JASON
Position OWNER
Phone (218) 741-0089
Fax
Practice Location
302 CHESTNUT ST
SUITE 200
VIRGINIA MN, 55792-2541, US
Phone (218) 741-0089
Fax
Business Location
302 CHESTNUT ST
SUITE 200
VIRGINIA MN, 55792-2541, US
Phone (218) 741-0089
Fax
Toxanomy
Taxonomy Code 122300000X
License State Minnesota
License Number D12816
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According to our database, Range Family Dental Llc NPI is 1104218239, taxonomy code is 122300000X and license number is D12816, license state is located at Minnesota. Range Family Dental Llc physically located at 302 Chestnut St, Virginia MN, 55792-2541. NPI Number 1033115704 has the healthcare provider type.

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1104218239 NPI number is provided on an as is basis without warranty of any kind. 1104218239 is maintained by the National Plan & Provider Enumeration System. The contents of Range Family Dental Llc are for informational purposes only.