BLACK BEAR FAMILY DENTAL PC NPI 1609344894

NPI Information

NPI: 1609344894
Provider Name: BLACK BEAR FAMILY DENTAL PC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
1628 30TH ST NW
BEMIDJI, MN
ZIP 56601
Phone: (218) 444-2004
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BLACK BEAR FAMILY DENTAL PC is a dental clinic center in Bemidji, MN. BLACK BEAR FAMILY DENTAL PC NPI is 1609344894. The provider is registered as an organization entity type.

The provider's business location address is:

1628 30TH ST NW
BEMIDJI, MN
ZIP 56601-690
Phone: (218) 444-2004

The provider's authorized official is Veronica Cooper .
The authorized official title is President and has the following contact phone number (218) 444-2004.

The enumeration date for this NPI number is 11/6/2018 and was last updated on 11/6/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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