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Organization

MSCTC COMMUNITY DENTAL CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS L BOE DDS,MBA (DIRECTOR DENTAL DEPARTMENT)
(218) 299-6819
Entity
Organization

Contact information

Practice address
1900 28TH AVE S, MOORHEAD, MN 56560-4830
(218) 299-6819
(218) 299-6532
Mailing address
1900 28TH AVENUE SOUTH, MOORHEAD, MN 56560
(218) 299-6819
(218) 299-6532

Taxonomy

Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary

Other

Enumeration date
12/12/2006
Last updated
08/22/2020
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