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BLACKDUCK DENTAL CLINIC
NPI 1003991944
Dentist - General Practice in Blackduck, MN

Active since October 26, 2006
49 SUMMIT AVE. SE, BLACKDUCK, MN 56630(218) 835-4227(218) 835-7512 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 21, 2022, Aug 22, 2020 (2 updates tracked since 2020).

About Blackduck Dental Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLACKDUCK DENTAL CLINIC (NPI 1003991944) is a healthcare organization registered as a general practice in Blackduck, Minnesota and active in the NPI registry since October 2006. The organization lists Paul R Bengtson, Dentist, as its authorized official.

NPPES Registry Identity

NPI1003991944
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameBLACKDUCK DENTAL CLINIC
Location Address49 SUMMIT AVE. SEBlackduck, MN 56630
Mailing AddressPo Box 308Blackduck, MN 56630-0308 · (218) 835-4227 · Fax (218) 835-7512
Phone(218) 835-4227
Fax(218) 835-7512
Organization SubpartNo
Authorized OfficialPaul R BengtsonDentist · (218) 835-4227
Enumeration DateOctober 26, 2006
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1003991944 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MN · 7789
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
49 SUMMIT AVE. SE, Blackduck, MN 56630
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Other Identifiers 1

Other81202BEMN · Blue Cross Blue Shield

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blackduck Dental Clinic's NPI number?

The NPI number for Blackduck Dental Clinic is 1003991944. It was assigned to this organization in the NPPES registry on October 26, 2006.

Where is Blackduck Dental Clinic located?

Blackduck Dental Clinic is located at 49 Summit Ave. SE, Blackduck, MN 56630. The listed phone number is (218) 835-4227.

What is Blackduck Dental Clinic's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Blackduck Dental Clinic was last updated on July 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.