Organization
PHS INDIAN HOSPITAL
Active
Other names
PHS INDIAN HOSPITAL-DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE MARIE THUNDER (BUSINESS OFFICE MANAGER)
(218) 679-3912
Entity
Organization
Contact information
Practice address
PO BOX 497, REDLAKE, MN 56671-0497
(218) 679-3912
(218) 679-0181
Mailing address
24760 HOSPITAL DRIVE, BOX 497 C/O BUSINESS OFFICE, RED LAKE, MN 56671
(218) 679-3912
(218) 679-0181
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
MN
Other
Enumeration date
08/17/2017
Last updated
07/21/2022
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