Organization
DONABAUER FAMILY DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLY J DONABAUER (PRESIDENT)
(218) 233-1754
Entity
Organization
Contact information
Practice address
211 5TH ST S, MOORHEAD, MN 56560-2714
(218) 233-1754
(218) 291-1640
Mailing address
211 5TH ST S, MOORHEAD, MN 56560-2714
(218) 233-1754
(218) 291-1640
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
11563
MN
Other
Enumeration date
06/09/2008
Last updated
06/09/2008
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