Organization
SHETEK DENTAL CARE PA
Active
Parent organization
SHETEK DENTAL CARE PA
Other names
Shetek Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHETEK DENTAL CARE PA
Authorized official
MS. NARLA NORINE HULSTEIN CDA, RDA (CLINIC MANAGER)
(507) 836-1000
Entity
Organization
Contact information
Practice address
106 2ND ST NW, FULDA, MN 56131
(507) 425-2276
(507) 425-2769
Mailing address
106 2ND ST NW, FULDA, MN 56131-1101
(507) 425-2276
(507) 425-2769
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12229
MN
122300000X
Dentist
Primary
8209
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629187364
—
MN
05
—
1881639201
—
MN
Enumeration date
11/25/2014
Last updated
11/25/2014
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