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Organization
4TH AVENUE DENTAL, PA, DBA OAK PARK DENTAL
Active
Organization
4TH AVENUE DENTAL, PA, DBA OAK PARK DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA ASCHEMAN (SUPERVISOR/OWNER)
(320) 629-2282
Entity
Organization
Contact information
Practice address
505 JOHNSON AVE SE, PINE CITY, MN 55063-2108
(320) 629-2282
(320) 629-3357
Mailing address
505 JOHNSON AVE SE, PINE CITY, MN 55063-2108
(320) 629-2282
(320) 629-3357
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11935
MN
Other
Enumeration date
01/15/2014
Last updated
01/15/2014
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