Friendly Dental is a Dental in Worthington, Minnesota. Friendly Dental practices all healthcare services and medical treatments related to Dental. The NPI Number for Friendly Dental is 1770672958. The last update date is 2023-03-07.
Friendly Dental's current location address is 1316 Mcmillan St, Worthington, Minnesota. You can contact this provider via phone number 5073765525 and fax number 5073763796. The mailing address for Friendly Dental is 1316 Mcmillan St, Worthington, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Friendly Dental |
|---|---|
| Address | 1316 Mcmillan St, Worthington, Minnesota |
| Phone Number | 5073765525 |
| Fax Number | 5073763796 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Johnson Lee Jerry |
| Credentials | DDS |
| Telephone Number | 5073765525 |
NPI Number Detail
| NPI Number | 1770672958 |
|---|---|
| Provider Enumeration Date | 2006-10-12 |
| Last Updated Date | 2023-03-07 |
Provider Mailing Address Detail
| Address | 1316 Mcmillan St |
|---|---|
| City | Worthington |
| State | Minnesota (MN) |
| Post Code | 561871646 |
| Phone Number | 5073765525 |
| Fax Number | 5073763796 |
Provider's Primary Taxonomy Detail
| Speciality | Dental |
|---|---|
| Taxonomy | 261Qd0000X |
| Licence No | 10185 |
|
Definition: Provides general and specialized dental care and oral surgery. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 820-6852 | UNITED CONCORDIA | ||
| 46483JO | BLUE CROSS BLUE SHIELD | ||
| 675-2375 | MN | TAX ID | |
| 10185 | FM | DELTA | |
| 687623400 | MN | MINNESOTA MEDICAID - OFC. | |
| 964114 | IA | DELTA | |
| 10185 | FM | DENTAL LICENSE |
Post Comment/ Review Below
What is the Friendly Dental's unique identification number?
The Friendly Dental has been assigned the NPI (National Provider Identifier) Number 1770672958 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you provide the complete address where Friendly Dental is physically located?
The Friendly Dental is situated at the following address: 1316 Mcmillan St, Worthington, MN 561871646.
What is the area of specialization for Friendly Dental, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Friendly Dental is Dental, and the corresponding taxonomy code that categorizes this area of expertise is 261Qd0000X.
On what date did Friendly Dental receive its 1770672958 assignment from the Centers for Medicare & Medicaid Services?
The Friendly Dental was assigned its 1770672958 on 2006-10-12, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the Friendly Dental's information last updated?
The Friendly Dental's information was last updated on 2023-03-07.
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