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Organization

HEADWATERS DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PATRICIA WINSLOW FEIL (DDS/OWNER)
(218) 333-6515
Entity
Organization

Contact information

Practice address
2229 23RD ST NW, BEMIDJI, MN 56601-5503
(218) 333-6515
(218) 333-6519
Mailing address
2229 23RD ST NW, BEMIDJI, MN 56601-5503
(218) 333-6515
(218) 333-6519

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
96501800
MN
Enumeration date
08/14/2006
Last updated
03/28/2016
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