| Chisago Lakes Dental Services Llc | |
|
12745 N 1st Ave Lindstrom MN 55045-9585 | |
| (763) 360-1465 | |
| Not Available |
| Full Name | Chisago Lakes Dental Services Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12745 N 1st Ave, Lindstrom, Minnesota |
| Authorized Official Name and Position | Michael Hursh (OWNER) |
| Authorized Official Contact | 7633601465 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chisago Lakes Dental Services Llc 12745 N 1st Ave P. O. Box 39 Lindstrom MN 55045-9585 Ph: (763) 360-1465 | Chisago Lakes Dental Services Llc 12745 N 1st Ave Lindstrom MN 55045-9585 Ph: (763) 360-1465 |
| NPI Number | 1306255070 |
|---|---|
| Provider Enumeration Date | 08/07/2014 |
| Last Update Date | 08/07/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306255070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8021 (Minnesota) | Primary |
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