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Organization

FAIRMONT DENTAL PROFESSIONALS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MITCH WEILAND (ASSISTANT CONTROLLER)
(608) 343-0818
Entity
Organization

Contact information

Practice address
1950 CENTER CREEK DR STE 200, FAIRMONT, MN 56031-3430
(507) 238-2812
Mailing address
8025 EXCELSIOR DR, MADISON, WI 53717-1900
(608) 343-0818

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
09/23/2021
Last updated
09/23/2021
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