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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

NPI # 1548540321
LBN Legal business name ADVANCED FAMILY DENTAL PA
Authorized official RACHEL POPPEL - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/24/2011
Last updated 04/13/2020 - About 6 years ago
Identifiers
MN License # D12409
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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