Organization
MOOSECREEK DENTAL CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN MCCOLLUM DDS (DENTIST)
(218) 556-8083
Entity
Organization
Contact information
Practice address
2229 23RD ST NW, BEMIDJI, MN 56601-5503
(218) 333-6515
Mailing address
50757 WINTERBERRY DR, CASS LAKE, MN 56633-3148
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/20/2025
Last updated
11/20/2025
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