Organization
MISSISSIPPI HEADWATERS AREA DENTAL HEALTH CENTER, INC.
Active
Parent organization
MISSISSIPPI HEADWATERS AREA DENTAL HEALTH CENTER
Other names
Northern Dental Access Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
MISSISSIPPI HEADWATERS AREA DENTAL HEALTH CENTER
Authorized official
ERICA ANNE LUNDBERG MBA (DIRECTOR OF FINANCE AND OPERATIONS)
(218) 444-9147
Entity
Organization
Contact information
Practice address
13 MAIN AVE N, BAGLEY, MN 56621-8315
(218) 694-6571
Mailing address
1405 ANNE ST NW, BEMIDJI, MN 56601-5113
(218) 444-9147
(218) 444-9252
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/15/2023
Last updated
08/15/2023
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