| Amundson Family Dentistry | |
|
6939 Pine Arbor Dr S Ste 104 Cottage Grove MN 55016-4642 | |
| (651) 459-3514 | |
| (651) 459-4537 |
| Full Name | Amundson Family Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6939 Pine Arbor Dr S, Cottage Grove, Minnesota |
| Authorized Official Name and Position | Lisa Kathleen Amundson (OWNER/DENTIST) |
| Authorized Official Contact | 6514593514 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amundson Family Dentistry 6939 Pine Arbor Dr S Ste 104 Cottage Grove MN 55016-4642 Ph: (651) 459-3514 | Amundson Family Dentistry 6939 Pine Arbor Dr S Ste 104 Cottage Grove MN 55016-4642 Ph: (651) 459-3514 |
| NPI Number | 1043656168 |
|---|---|
| Provider Enumeration Date | 05/15/2013 |
| Last Update Date | 05/15/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043656168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D12460 (Minnesota) | Primary |
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