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NPI 1609298355

OrganizationActive

4th Avenue Dental, PA, Dba Oak Park Dental

NPI 1609298355 · General Practice Dentistry · Pine City, MN

Provider details

NPI number: 1609298355
Entity type: Organization
Primary specialty: General Practice DentistryDental Providers
Authorized official: Alicia Ascheman, Supervisor/Owner
License: D11935 (MN)

Practice location

505 Johnson Ave Se

Pine City, MN 55063-2108

Phone: (320) 629-2282

Fax: (320) 629-3357

More MN providers

Mailing address

505 Johnson Ave Se

Pine City, MN 55063-2108

Registry dates

Enumerated: 2014-01-15
Last updated: 2014-01-15

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

4th Avenue Dental, PA, Dba Oak Park Dental — NPI 1609298355, Pine City, MN | NPI Central