Organization
JOHN T. POWERS DENTAL P.C.
Active
Other names
Main Street Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN THOMAS POWERS D.D.S. (OWNER/PRESIDENT)
(320) 269-6406
Entity
Organization
Contact information
Practice address
315 N 1ST ST, MONTEVIDEO, MN 56265-1405
(320) 269-6406
(320) 269-6408
Mailing address
315 N 1ST ST, MONTEVIDEO, MN 56265-1405
(320) 269-6406
(320) 269-6408
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8597
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6885209-00
—
MN
Enumeration date
02/02/2012
Last updated
02/02/2012
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