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Contact Information

MAIN STREET DENTAL MC
405 E MAIN STREET
BLOOMING PRAIRIE, MN55917
 Phone: 507-583-2141
 Fax: 507-583-7574
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for MAIN STREET DENTAL MC

NPI # 1649244914
LBN Legal business name MAIN STREET DENTAL MC
Authorized official JOHN FLOR - (CHIEF FINANCIAL OFFICER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/14/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
MN License # 2865172
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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