Organization
PINE RIVER DENTAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAIME PREBLE (GENERAL DENTIST)
(218) 587-4438
Entity
Organization
Contact information
Practice address
203 PARK AVE W, PINE RIVER, MN 56474-4495
(218) 587-4438
Mailing address
PO BOX 650, PINE RIVER, MN 56474-0650
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D13393
MN
Other
Enumeration date
06/10/2014
Last updated
06/10/2014
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