NPI | 1356611404 |
---|---|
Other Name | OPEN DOOR HEALTH CENTER - MOBILE DENTAL |
Entity Type | Organization |
Authorized Contact | DOUGLAS L JAEGER CEO 507-344-5500 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2012-01-06 |
Last Update Date | 2016-04-04 |