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Organization

DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NATHAN PEDERSEN DDS (CEO)
(218) 263-8381
Entity
Organization

Contact information

Practice address
802 W 42ND ST, HIBBING, MN 55746
(218) 263-8381
(218) 263-8383
Mailing address
802 W 42ND ST, HIBBING, MN 55746
(218) 263-8381
(218) 263-8383

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
69151DE
BLUE CROSS BLUE SHIELD
MN
Enumeration date
03/28/2007
Last updated
08/22/2022
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