Eagle Lake Family Dentistry, P.a. | |
104 Plainview Street Box 97 Eagle Lake MN 56024 | |
(507) 257-3800 | |
(507) 257-3456 |
Full Name | Eagle Lake Family Dentistry, P.a. |
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Speciality | Dentist - General Practice |
Location | 104 Plainview Street, Eagle Lake, Minnesota |
Authorized Official Name and Position | Bradley Allan Holmberg (PRESIDENT) |
Authorized Official Contact | 5072573800 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Eagle Lake Family Dentistry, P.a. 104 Plainview Street Box 97 Eagle Lake MN 56024 Ph: (507) 257-3800 | Eagle Lake Family Dentistry, P.a. 104 Plainview Street Box 97 Eagle Lake MN 56024 Ph: (507) 257-3800 |
NPI Number | 1528138948 |
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Provider Enumeration Date | 11/09/2006 |
Last Update Date | 02/09/2016 |
Identifier | Type | State | Issuer |
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1528138948 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | (Minnesota) | Primary |