Organization Name: | EXCELSIOR DENTAL CARE |
NPI Number: | 1124456421 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STACY HILLMAN (FRONT DESK MANAGER) |
Mailing Address: | 7814 Excelsior Rd Baxter |
State: | MN US |
Postal Code: | 564258427 |
Phone Number: | 2188298863 |
Fax Number: | 2188298863 |
NPI Enumeration Date: | 10/23/2013 |
NPI Last Update Date: | 10/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 305S00000X |
License Number: | 9105 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Managed Care Organizations |
Taxonomy Classification: | Point of Service |
Taxonomy Specialization: | |
Taxonomy Definition: | This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |