Organization
OPEN DOOR HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS L JAEGER JR. (CEO)
(507) 344-5500
Entity
Organization
Contact information
Practice address
1025 10TH AVE, CLARKFIELD, MN 56223-1301
(320) 669-7564
Mailing address
309 HOLLY LN, MANKATO, MN 56001-5422
(507) 388-2120
(507) 388-8351
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
261QF0400X
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201094100
—
MN
Enumeration date
07/06/2016
Last updated
07/06/2016
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