| NPI | 1578670188 |
|---|---|
| Doing Business As | INDIAN HEALTH BOARD DENTAL |
| Entity Type | Organization |
| Authorized Contact | TIA SHAW Him/Billing Manager 612-721-9830 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: MN 6115875) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2021-06-01 |