Organization
OAK PARK DENTAL - PINE CITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENIE KUBLE (ACCESS MANAGER)
(920) 450-0157
Entity
Organization
Contact information
Practice address
505 JOHNSON AVE SE, PINE CITY, MN 55063-2108
(320) 629-2282
Mailing address
505 JOHNSON AVE SE, PINE CITY, MN 55063-2108
(320) 329-2282
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/14/2022
Last updated
07/14/2022
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