Organization
NORTH COUNTRY DENTAL SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN E. LUETH D.D.S. (DENTIST)
(218) 751-1111
Entity
Organization
Contact information
Practice address
1311 BEMIDJI AVE N, BEMIDJI, MN 56601-3811
(218) 751-1111
(218) 444-6318
Mailing address
1311 BEMIDJI AVE N, P.O. BOX 1310, BEMIDJI, MN 56601-3811
(218) 751-1111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9539
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
843220100
—
MN
Enumeration date
05/05/2008
Last updated
08/17/2009
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