Organization
PRAIRIE PINES DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KARISSA GOETSCH DDS (OWNER DENTIST)
(320) 309-5882
Entity
Organization
Contact information
Practice address
109 JOHNSON AVE N, FOSSTON, MN 56542-1327
(320) 309-5882
Mailing address
109 JOHNSON AVE N, FOSSTON, MN 56542-1327
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/14/2022
Last updated
08/14/2022
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