Evolve Orthodontics | |
510 22nd Ave E Ste 702 Alexandria MN 56308-4653 | |
(612) 804-4028 | |
Not Available |
Full Name | Evolve Orthodontics |
---|---|
Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 510 22nd Ave E Ste 702, Alexandria, Minnesota |
Authorized Official Name and Position | Dustin Matthew Ditch (OWNER) |
Authorized Official Contact | 6128044028 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Evolve Orthodontics 41625 Bur Oak Hills Rd Pelican Rapids MN 56572-7448 Ph: () - | Evolve Orthodontics 510 22nd Ave E Ste 702 Alexandria MN 56308-4653 Ph: (612) 804-4028 |
NPI Number | 1639677735 |
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Provider Enumeration Date | 01/24/2018 |
Last Update Date | 01/24/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639677735 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | D13650 (Minnesota) | Primary |
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