Provider Demographics
NPI:1770305773
Name:KALINA DENTAL
Entity type:Organization
Organization Name:KALINA DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:KALINA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:507-317-8975
Mailing Address - Street 1:1531 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-5192
Mailing Address - Country:US
Mailing Address - Phone:507-625-2021
Mailing Address - Fax:507-625-5501
Practice Address - Street 1:1531 ADAMS ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-5192
Practice Address - Country:US
Practice Address - Phone:507-625-2021
Practice Address - Fax:507-625-5501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1194289678OtherNPI
MN1477383222OtherNPI
MN1780691048OtherNPI