| Glacial Lakes Dental, Pllp | |
|
509 16th Ave Sw Willmar MN 56201-4118 | |
| (320) 235-7742 | |
| (320) 235-4045 |
| Full Name | Glacial Lakes Dental, Pllp |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 509 16th Ave Sw, Willmar, Minnesota |
| Authorized Official Name and Position | Dawn Renae Platt (OFFICE MANAGER) |
| Authorized Official Contact | 3202357742 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glacial Lakes Dental, Pllp 509 16th Ave Sw Willmar MN 56201-4118 Ph: (320) 235-7742 | Glacial Lakes Dental, Pllp 509 16th Ave Sw Willmar MN 56201-4118 Ph: (320) 235-7742 |
| NPI Number | 1184923096 |
|---|---|
| Provider Enumeration Date | 03/17/2011 |
| Last Update Date | 03/17/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184923096 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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