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Organization
THOMAS P. DIMICH, DDS, PA
Active
Organization
THOMAS P. DIMICH, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS PETER DIMICH DDS (PRESIDENT)
(218) 681-2545
Entity
Organization
Contact information
Practice address
310 RED LAKE BLVD., THIEF RIVER FALLS, MN 56701-2133
(218) 681-2545
(218) 681-2560
Mailing address
PO BOX 655, THIEF RIVER FALLS, MN 56701-2133
(218) 681-2545
(218) 681-2560
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7534
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
376513000
MN HEALTHCARE PROGRAM
MN
Enumeration date
02/15/2011
Last updated
02/15/2011
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