Organization
DOWNTOWN DENTAL CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KURT DAVID STODOLA DDS (DOCTOR VICE PRESIDENT)
(218) 485-4455
Entity
Organization
Contact information
Practice address
304 ELM AVE, MOOSE LAKE, MN 55767
(218) 485-4455
(218) 485-0227
Mailing address
PO BOX 587, 304 ELM AVE, MOOSE LAKE, MN 55767
(218) 485-4455
(218) 485-0227
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/12/2006
Last updated
08/22/2020
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