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NPI Code Detail

MEDICARE: COMPASS DENTAL PA

MEDICARE: COMPASS DENTAL PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/CenterD11112MN

General Provider Information

NPI Number : 1932644648
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPASS DENTAL PA
Provider Business Mailing Address
First Line : 114 3RD ST N
Second Line :
City : CANNON FALLS
State : MN
Zip : 55009-2011
Country : US
Telephone Number : 507-263-4501
Fax Number :
Provider Business Practice Location Address
First Line : 114 3RD ST N
Second Line :
City : CANNON FALLS
State : MN
Zip : 55009-2011
Country : US
Telephone Number : 507-263-4501
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. DANIEL CURTIS CALLSTROM
Credential : DDS
Telephone Number : 507-263-4501
Provider Enumeration Date : 01/04/2017
Last Update Date : 01/04/2017

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Directions to “COMPASS DENTAL PA ” Practice Location

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