Organization
BASSILLEANN P.A.
Active
Other names
Clearwater Family and Sedation Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNE MARIE MEYER (ADMINISTRATION)
(320) 558-6810
Entity
Organization
Contact information
Practice address
505 N. WALNUT STREET, CLEARWATER, MN 55320
(320) 558-6810
(320) 558-6006
Mailing address
PO BOX 187, CLEARWATER, MN 55320-0187
(320) 558-6810
(320) 558-6006
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11975
MN
Other
Enumeration date
12/05/2007
Last updated
12/05/2007
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