| NPI | 1376814939 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2012-01-13 |
| Last Updated | 2012-01-13 |
| Authorized Official | Scott Larson President Phone: 2188354227 |
| Mailing Address | Po Box 308 Blackduck, MN 56630-0308 United States Phone: (218) 835-4227 📍 View Map |
| Primary Practice Address | 49 Summit Ave. E. Blackduck, MN 56630-9727 United States Phone: (218) 835-4227 📍 View Map |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 1223G0001X – Dentist, General Practice | MN | D12251 |
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About NPI 1376814939
Blackduck Dental Clinic Psc is an organization registered in the CMS NPPES NPI Registry with NPI number 1376814939. The primary specialty listed is Dentist, General Practice. The organization is located in Blackduck, MN. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2012-01-13. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1376814939?
NPI 1376814939 belongs to Blackduck Dental Clinic Psc, a Dentist, General Practice in Blackduck, MN. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1376814939 active?
The current status of NPI 1376814939 in the NPPES registry is Active. The record was last updated on 2012-01-13.
What specialty is NPI 1376814939?
NPI 1376814939 is classified under the taxonomy Dentist, General Practice. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1376814939?
You can verify NPI 1376814939 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1376814939?
The primary practice address on file for NPI 1376814939 is 49 Summit Ave. E., Blackduck, MN 56630-9727. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1376814939 issued?
NPI 1376814939 was first issued (enumerated) on 2012-01-13. The NPPES record was last updated on 2012-01-13.
Practice Location Map
Blackduck Dental Clinic Psc is located at 49 Summit Ave. E., Blackduck, MN. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Blackduck Dental Clinic Psc. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1376814939. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Dentist, General Practice | D12251 | MN |