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Organization
MAIN STREET DENTAL MC
Active
Organization
MAIN STREET DENTAL MC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN M FLOR DDS (CHIEF FINANCIAL OFFICER)
(507) 583-2141
Entity
Organization
Contact information
Practice address
405 E MAIN STREET, BLOOMING PRAIRIE, MN 55917
(507) 583-2141
(507) 583-7574
Mailing address
405 E MAIN STREET, BLOOMING PRAIRIE, MN 55917
(507) 583-2141
(507) 583-7574
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2865172
MN
Other
Enumeration date
02/14/2006
Last updated
08/22/2020
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