Organization
OPEN DOOR HEALTH CENTER
Active
Organization
OPEN DOOR HEALTH CENTER
Active
Other names
Open Door Health Center - Mobile Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS L JAEGER JR. (CEO)
(507) 344-5500
Entity
Organization
Contact information
Practice address
309 HOLLY LN, MANKATO, MN 56001-5422
(507) 388-2120
(507) 388-3924
Mailing address
309 HOLLY LN, MANKATO, MN 56001-5422
(507) 388-2120
(507) 388-3924
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
01/06/2012
Last updated
04/04/2016
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