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Organization

JACK M. FIEDLER, D.D.S.,P.A.

Active
Other names
d/b/a Esthetic Family Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JACK M. FIEDLER D.D.S. (OWNER)
(320) 848-2611
Entity
Organization

Contact information

Practice address
150 GREENWOOD AVE W, BOX 547, HECTOR, MN 55342
(320) 848-2611
(320) 848-2611
Mailing address
150 GREENWOOD AVE W, BOX 547, HECTOR, MN 55342
(320) 848-2611
(320) 848-2611

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12373
MN

Other

Enumeration date
01/04/2011
Last updated
01/04/2011
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