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Organization
NORTHLAND DENTAL LTD.
Active
Organization
NORTHLAND DENTAL LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOM G ANDERSON DDS (OWNER DENTIST)
(218) 236-7076
Entity
Organization
Contact information
Practice address
2121 HIGHWAY 10 E, MOORHEAD, MN 56560-2559
(218) 236-7076
(218) 236-4999
Mailing address
2121 HIGHWAY 10 E, MOORHEAD, MN 56560-2559
(218) 236-7076
(218) 236-4999
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
D12404
MN
261QD0000X
Dental Clinic/Center
Primary
MN 9657
MN
Other
Enumeration date
01/05/2012
Last updated
01/05/2012
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