Organization
ADVANCED FAMILY DENTAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RACHEL ANNE POPPEL (OWNER)
(507) 373-5968
Entity
Organization
Contact information
Practice address
2717 EKKO AVE, ALBERT LEA, MN 56007-2070
(507) 373-5968
(507) 540-1395
Mailing address
2717 EKKO AVE, ALBERT LEA, MN 56007-2070
(507) 373-5968
(507) 540-1395
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12409
MN
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
08/24/2011
Last updated
04/13/2020
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