MSCTC COMMUNITY DENTAL CLINIC (NPI# 1548320112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548320112 |
| Entity Type | Organization |
| Organization Name | MSCTC COMMUNITY DENTAL CLINIC |
| Practice Address |
1900 28th Ave S Moorhead MN 56560-4830 |
| Mailing Address |
1900 28th Avenue South Moorhead MN 56560 |
| Practice Telephone | 2182996819 |
| Practice Fax Number | 2182996532 |
| Mailing Telephone | 2182996819 |
| Mailing Fax Number | 2182996532 |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. THOMAS L BOE (DIRECTOR DENTAL DEPARTMENT) |
| Authorized Official Telephone | 2182996819 |
| Authorized Official Credential | DDS,MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223D0001X |
Dentist Specialization: Dental Public Health |
Dental Providers |
| Street Address |
1900 28TH AVE S |
| City | MOORHEAD |
| State | MN |
| Zip Code | 56560-4830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326109869 | Thomas Lura Boe | Dentist | 1900 28th Ave S, Moorhead, MN 56560-4830 | 2006-12-12 |
| 1518027754 | Minnesota State Community and Technical College - Dental | Dentist | 1900 28th Ave S, Moorhead, MN 56560-4830 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386298859 | Anna Mckay Fox | Pharmacist | 4000 28th Avenue S, Moorhead, MN 56560 | 2019-08-01 |
| 1972019727 | Michael Wayne Hilliard | Specialist/Technologist | 649 17th St S, Moorhead, MN 56560 | 2017-12-15 |
| 1508217183 | Kristen Johnson | Nurse Practitioner | 801 Belsly Boulevard, Moorhead, MN 56560 | 2016-06-25 |
| 1861877052 | Midwest Mental Health Clinic | Nurse Practitioner | 819 30th Ave S Office 206 Suite B, Moorhead, MN 56560 | 2015-07-29 |
| 1083037709 | Drake Counseling Services, Inc. | Clinic/Center | 715 11th Street North, Suite 204, Moorhead, MN 56560 | 2014-01-31 |
| 1710310917 | Lamar Terrell Hill | Social Worker | 420 Center Ave Ste 102, Moorhead, MN 56560 | 2013-08-12 |
| 1982956140 | Lilac Homes Corporation | Assisted Living Facility | 2615 Parkview Dr, Moorhead, MN 56560 | 2012-10-11 |
| 1487918462 | Paige Joy Hanson | Massage Therapist | 805 14th St. So., Msum Wellness Center, Moorhead, MN 56560 | 2012-06-25 |
| 1972809408 | Cslm, LLC | Assisted Living Facility | 2401 South 11th Street, Moorhead, MN 56560 | 2011-02-01 |
| 1972814846 | Paul Michael Fluto | Pharmacist | 3000 Hwy 10 East, Mooehead, MN 56560 | 2010-06-25 |
| Find all providers in zip 56560 | ||||
| Taxonomy Code | 1223D0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Dental Public Health |
| The science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194095778 | Matthew Allen Olson | Dentist | 715 11th St N Ste 106b, Moorhead, MN 56560-2000 | 2012-01-12 |
| 1518027754 | Minnesota State Community and Technical College - Dental | Dentist | 1900 28th Ave S, Moorhead, MN 56560-4830 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076073 | Rae Ann Ann Swanson | Dentist | 755 Florida Ave S, Minneapolis, MN 55426-1784 | 2020-09-02 |
| 1083178149 | Lift Dental Pllc | Dentist | 124 2nd St S Ste 101, Stillwater, MN 55082-5179 | 2019-01-23 |
| 1669842662 | Children's Dental Services | Dentist | 229 W Lake St, Chisholm, MN 55719 | 2015-10-02 |
| 1407224827 | Children's Dental Services | Dentist | 325 N Sibley Ave, Litchfield, MN 55355-2150 | 2015-09-02 |
| 1801118039 | Omar Dyab Dds Pa | Dentist | 13590 Northdale Blvd, Suite 300, Rogers, MN 55374-2150 | 2010-02-15 |
| 1407973605 | Childrens Dental Services Inc | Dentist | 636 Broadway St. Ne, Minneapolis, MN 55413 | 2007-03-23 |
| 1437287679 | Mississippi Headwaters Area Dental Health Center, Inc. | Dentist | 616 America Ave Nw Ste 340, Attention Mary Marchell, Bemidji, MN 56601-3871 | 2007-03-01 |
| 1205991866 | Fergus Falls Dental Group | Dentist | 1121 Pebble Lake Rd, Fergus Falls, MN 56537 | 2006-12-26 |
| 1437238052 | Tracey Roseann Charles | Dentist | 9345 Calypso Trail Nw, Bemidji, MN 56601 | 2006-11-03 |
| 1386722585 | William Lynn Canada | Dentist | 619 Kay Ave Se, Bemidji, MN 56601-3638 | 2006-11-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.