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Organization
NORTHERN DENTAL PARTNERS AND ASSOCIATES PLLC
Active
Organization
NORTHERN DENTAL PARTNERS AND ASSOCIATES PLLC
Active
Other names
Miskovich Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER JOHN MISKOVICH DDS (DENTIST/PARTNER)
(218) 326-3437
Entity
Organization
Contact information
Practice address
1121 SE 4TH AVE, GRAND RAPIDS, MN 55744-3956
(218) 326-3437
(218) 327-1211
Mailing address
1121 SE 4TH AVE, GRAND RAPIDS, MN 55744-3956
(218) 326-3437
(218) 327-1211
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
274L7MI27SL
BCBS
MN
05
—
842936700
—
MN
Enumeration date
01/20/2022
Last updated
01/20/2022
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