Provider Demographics
NPI:1750828190
Name:WINSTED DENTAL PLLC
Entity Type:Organization
Organization Name:WINSTED DENTAL PLLC
Other - Org Name:LITCHFIELD DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:SANDSTEDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-275-2954
Mailing Address - Street 1:329 E HIGHWAY 12
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55355-2295
Mailing Address - Country:US
Mailing Address - Phone:320-693-8939
Mailing Address - Fax:
Practice Address - Street 1:329 E HIGHWAY 12
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55355-2295
Practice Address - Country:US
Practice Address - Phone:320-693-8939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental