Organization
CORRECTIONAL DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE ANN BENOIT (PRACTICE ADMINISTRATOR)
(320) 774-3131
Entity
Organization
Contact information
Practice address
3152 COUNTY ROAD 74, SAINT CLOUD, MN 56301-8904
(320) 774-3131
(320) 217-2877
Mailing address
3152 COUNTY ROAD 74, SAINT CLOUD, MN 56301-8904
(320) 774-3131
(320) 217-2877
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/24/2022
Last updated
08/24/2022
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