Organization
GRANITE FALLS FAMILY DENTISTRY
Active
Parent organization
MONTEVIDEO FAMILY DENTISTRY, P.A.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MONTEVIDEO FAMILY DENTISTRY, P.A.
Authorized official
JAMES K ZENK D.D.S. (SENIOR PARTNER)
(320) 269-6416
Entity
Organization
Contact information
Practice address
1265 6TH ST, GRANITE FALLS FAMILY DENTISTRY, GRANITE FALLS, MN 56241
(320) 269-6416
Mailing address
1265 6TH ST, GRANITE FALLS FAMILY DENTISTRY, GRANITE FALLS, MN 56241
(320) 269-6416
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8908
MN
1223G0001X
General Practice Dentistry
D10942
MN
1223G0001X
General Practice Dentistry
D12332
MN
Other
Enumeration date
12/15/2010
Last updated
12/15/2010
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