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General NPI Number Information
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NPI Number | 1932362589
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Entity Type | Organization
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Legal Business Name | VALLEY DENTAL ASSOCIATES
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 219 S 2ND ST VALLEY DENTAL CARE
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City | LESUEUR
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State | MN
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Zip | 56058-1903
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Country | US
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Telephone | 507-665-2275
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Fax | 507-665-6842
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Provider Business Mailing Address
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Address Line | 219 S 2ND ST VALLEY DENTAL CARE
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City | LESUEUR
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State | MN
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Zip | 56058-1903
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Country | US
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Telephone | 507-665-2275
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Fax | 507-665-6842
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Authorized Official
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Title or Position | CEO
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Name | DR. JOHN MICHAEL DUNN
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Credential | DDS
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Telephone | 507-665-2275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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