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Organization
MISSISSIPPI HEADWATERS AREA DENTAL HEALTH CENTER, INC.
Active
Organization
MISSISSIPPI HEADWATERS AREA DENTAL HEALTH CENTER, INC.
Active
Parent organization
MISSISSIPPI HEADWATERS AREA DENTAL HEALTH CENTER
Other names
Northern Dental Access Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
MISSISSIPPI HEADWATERS AREA DENTAL HEALTH CENTER
Authorized official
ERICA ANNE LUNDBERG MBA (DIRECTOR OF OPERATIONS)
(218) 444-9147
Entity
Organization
Contact information
Practice address
132 3RD ST W, HALSTAD, MN 56548-4015
(218) 456-2238
(218) 456-2248
Mailing address
1405 ANNE ST NW, BEMIDJI, MN 56601-5113
(218) 444-9147
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/30/2018
Last updated
10/30/2018
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