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Contact Information

ADVANCED FAMILY DENTAL PA
2717 EKKO AVE
ALBERT LEA, MN56007-2070
 Phone: 507-373-5968
 Fax: 507-540-1395
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for ADVANCED FAMILY DENTAL PA · (Female)

NPI # 1548540321
Status Active
Credentials
Entity Individual
Enumeration date 08/24/2011
Last updated 04/13/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • MN License # D12409
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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