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Organization
CLARISSA FAMILY DENTAL
Active
Organization
CLARISSA FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERALYN B BOWIE D.D.S. (OWNER)
(218) 756-2234
Entity
Organization
Contact information
Practice address
214 MAIN ST W, CLARISSA, MN 56440-4500
(218) 756-2234
(218) 756-2427
Mailing address
214 MAIN ST W, P. O. BOX 416, CLARISSA, MN 56440-4500
(218) 756-2234
(218) 756-2427
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/17/2010
Last updated
03/17/2010
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