Provider Demographics
NPI:1275501249
Name:WINSTED GENTLE DENTAL CARE
Entity Type:Organization
Organization Name:WINSTED GENTLE DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:NEFF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:320-485-3881
Mailing Address - Street 1:123 FAIRLAWN AVE WEST
Mailing Address - Street 2:PO BOX 728
Mailing Address - City:WINSTED
Mailing Address - State:MN
Mailing Address - Zip Code:55395-0728
Mailing Address - Country:US
Mailing Address - Phone:320-485-3881
Mailing Address - Fax:320-485-4322
Practice Address - Street 1:123 FAIRLAWN AVE WEST
Practice Address - Street 2:
Practice Address - City:WINSTED
Practice Address - State:MN
Practice Address - Zip Code:55395-0728
Practice Address - Country:US
Practice Address - Phone:320-485-3881
Practice Address - Fax:320-485-4322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7778MN122300000X
MND11591122300000X
MND11889122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty