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General NPI Number Information
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NPI Number | 1972792430
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Entity Type | Organization
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Legal Business Name | HEALTH CENTERED DENTISTRY
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 10/22/2007
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Provider Practice Location Address
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Address Line | N7915 902ND ST
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City | RIVER FALLS
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State | WI
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Zip | 54022-4181
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Country | US
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Telephone | 715-426-7777
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Fax |
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Provider Business Mailing Address
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Address Line | N7915 902ND ST
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City | RIVER FALLS
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State | WI
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Zip | 54022-4181
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Country | US
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Telephone | 715-426-7777
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN LAUGHLIN III
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Credential | DDS
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Telephone | 715-426-7777
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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 | 1139G
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License Number State | WI
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