Provider Demographics
NPI:1770500464
Name:QUALE, GILBERTSON & MARTINKA, LTD.
Entity Type:Organization
Organization Name:QUALE, GILBERTSON & MARTINKA, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:QUALE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:320-235-2922
Mailing Address - Street 1:408 TROTT AVE SW
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-3280
Mailing Address - Country:US
Mailing Address - Phone:320-235-2922
Mailing Address - Fax:320-231-1719
Practice Address - Street 1:408 TROTT AVE SW
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-3280
Practice Address - Country:US
Practice Address - Phone:320-235-2922
Practice Address - Fax:320-231-1719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN61531223G0001X
MN78041223G0001X
MN86301223G0001X
MND124481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN=========OtherCORPORATION TAX ID #