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Organization
CHILDREN'S DENTAL SERVICES
Active
Organization
CHILDREN'S DENTAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH WOVCHA (EXECUTIVE DIRECTOR)
(612) 746-1530
Entity
Organization
Contact information
Practice address
325 N SIBLEY AVE, LITCHFIELD, MN 55355-2150
(612) 746-1530
(612) 746-1531
Mailing address
325 N SIBLEY AVE, LITCHFIELD, MN 55355-2150
(612) 746-1530
(612) 746-1531
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9212238
—
MN
Enumeration date
09/02/2015
Last updated
09/02/2015
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