Organization
WILLMAR FAMILY DENTISTRY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER JORGENSON D.D.S. (DENTIST)
(320) 235-2010
Entity
Organization
Contact information
Practice address
1016 1ST ST S, WILLMAR, MN 56201-3510
(320) 235-2010
(320) 235-7133
Mailing address
1016 1ST ST S, WILLMAR, MN 56201-3510
(320) 235-2010
(320) 235-7133
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9800
MN
125J00000X
Dental Therapist
DT54
MN
Other
Enumeration date
09/02/2015
Last updated
09/02/2015
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