Organization
NORTHERN DENTAL PARTNERS AND ASSOCIATES PLLC
Active
Other names
Miskovich Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER JOHN MISKOVICH DDS (DENTIST/PARTNER)
(218) 326-3437
Entity
Organization
Contact information
Practice address
1121 SE 4TH AVE, GRAND RAPIDS, MN 55744-3956
(218) 326-3437
(218) 327-1211
Mailing address
1121 SE 4TH AVE, GRAND RAPIDS, MN 55744-3956
(218) 326-3437
(218) 327-1211
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
274L7MI27SL
BCBS
MN
05
—
842936700
—
MN
Enumeration date
01/20/2022
Last updated
01/20/2022
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