Organization
MADISON AVENUE FAMILY DENTAL CENTER, LTD
Active
Other names
Advanced Dental Solutions
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN J. TORBENSON D.D.S. (CO-OWNER)
(507) 345-1284
Entity
Organization
Contact information
Practice address
608 E MADISON AVE, MANKATO, MN 56001-6112
(507) 345-1284
(507) 345-5723
Mailing address
608 E MADISON AVE, MANKATO, MN 56001-6112
(507) 345-1284
(507) 345-5723
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8804
MN
122300000X
Dentist
D11277
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3273752000
UNEMPLOYMENT TAX ID
MN
01
—
5723159
MN TAX ID
MN
01
—
8804
KEVIN TORBENSON, LICENSE
MN
01
—
D11277
NEUMANN, LICENSE #
MN
Enumeration date
07/26/2006
Last updated
03/07/2023
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