Mississippi Headwaters Area Dental Health Center, INC.
Clinic/Center, Dental in Halstad, MN. Organization (NPI-2).
NPI number1669949442
StatusActive
Last updated in NPPESOct 30, 2018
Details
- NPI
- 1669949442
- Entity type
- Organization (NPI-2)
- Legal business name
- Mississippi Headwaters Area Dental Health Center, INC.
- Organization subpart
- Yes
- Enumeration date
- Oct 30, 2018
- Last updated
- Oct 30, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Other names
- Northern Dental Access Center (Doing Business As)
Practice location
132 3rd St WHalstad, MN 56548-4015
Phone 218-456-2238 · Fax 218-456-2248
Mailing address
1405 Anne St NwBemidji, MN 56601-5113
Phone 218-444-9147
Authorized official
Erica Anne Lundberg
Director Of Operations
2184449147
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