Individual
TRENT JOHN NEISEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1016 1ST ST S, WILLMAR, MN 56201-3510
(320) 235-2010
Mailing address
1016 1ST ST S, WILLMAR, MN 56201-3510
(320) 235-2010
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10295
AZ
1223G0001X
General Practice Dentistry
Primary
D14013
MN
Other
Enumeration date
04/10/2018
Last updated
06/19/2023
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