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Organization

THIEF RIVER FALLS FAMILY DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL DALE EICKMAN DDS (PRESIDENT)
(218) 681-2545
Entity
Organization

Contact information

Practice address
310 RED LAKE BLVD, THIEF RIVER FALLS, MN 56701-2133
(218) 681-2545
(218) 681-2560
Mailing address
310 RED LAKE BLOULEVARD, THIEF RIVER FALLS, MN 56701-2133
(218) 681-2545
(218) 681-2560

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D12920
MN

Other

Enumeration date
04/27/2012
Last updated
04/27/2012
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