Organization
KITTSON DENTAL CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRAVIS AMMEN HANEL DDS (OWNER ONLY SHAREHOLDER)
(218) 843-3343
Entity
Organization
Contact information
Practice address
1010 SOUTH BIRCH, HALLOCK, MN 56728
(218) 843-3343
(218) 843-8053
Mailing address
1010 SOUTH BIRCH, HALLOCK, MN 56728
(218) 843-3343
(218) 843-8053
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D12024
MN
Other
Enumeration date
10/23/2006
Last updated
08/22/2020
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