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1136 Washington Ave Detroit Lakes MN 56501-3411 | |
(218) 847-2624 | |
(218) 847-5792 |
Full Name | |
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Speciality | Dentist |
Location | 1136 Washington Ave, Detroit Lakes, Minnesota |
Authorized Official Name and Position | Elizabeth G Mccauley (PARTNER) |
Authorized Official Contact | 2188472624 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1136 Washington Ave Detroit Lakes MN 56501-3411 Ph: (218) 847-2624 | 1136 Washington Ave Detroit Lakes MN 56501-3411 Ph: (218) 847-2624 |
NPI Number | 1407960230 |
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Provider Enumeration Date | 08/18/2006 |
Last Update Date | 06/11/2008 |
Identifier | Type | State | Issuer |
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1407960230 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | (* (Not Available)) | Primary |