Organization
THOMAS BACKENSTOSE
Active
Other names
Faribault Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE MEYER (OFFICE MANAGER)
(507) 332-7608
Entity
Organization
Contact information
Practice address
417 LINCOLN AVE NW, FARIBAULT, MN 55021-4952
(507) 332-7608
Mailing address
417 LINCOLN AVE NW, FARIBAULT, MN 55021-4952
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/04/2006
Last updated
08/22/2020
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