| Glen Lake Dental | |
|
14421 Excelsior Blvd Minnetonka MN 55345-5821 | |
| (952) 935-5212 | |
| (952) 935-1391 |
| Full Name | Glen Lake Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 14421 Excelsior Blvd, Minnetonka, Minnesota |
| Authorized Official Name and Position | Kristy Taran (DENTIST) |
| Authorized Official Contact | 9529355212 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glen Lake Dental 14421 Excelsior Blvd Minnetonka MN 55345-5821 Ph: (952) 935-5212 | Glen Lake Dental 14421 Excelsior Blvd Minnetonka MN 55345-5821 Ph: (952) 935-5212 |
| NPI Number | 1376386607 |
|---|---|
| Provider Enumeration Date | 06/14/2024 |
| Last Update Date | 06/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376386607 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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