Ham Lake Dental Pa is a dental clinic (Dentist - General Practice) in Ham Lake, Minnesota. The current practice location for Ham Lake Dental Pa is 17565 Central Ave Ne, Ham Lake, Minnesota. For appointments, you can reach them via phone at
(763) 434-4188. The mailing address for Ham Lake Dental Pa is 17565 Central Ave Ne, Ham Lake, Minnesota and phone number is (763) 434-4188.
Ham Lake Dental Pa is licensed to practice in Minnesota (license number D9362) and its
NPI number is 1205915881. This medical practice
does not participate in medicare program and thus may not accept your medicare insurance. You may check if they accept your insurance at
(763) 434-4188.
Dental Care Clinic Profile
| Full Name | Ham Lake Dental Pa |
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| Speciality | Dentist - General Practice |
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| Location | 17565 Central Ave Ne, Ham Lake, Minnesota |
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| Authorized Official Name and Position | Michele Marie Revoir (DENTIST) |
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| Authorized Official Contact | 7634344188 |
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| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ham Lake Dental Pa
17565 Central Ave Ne
Ham Lake
MN 55304
Ph: (763) 434-4188 | Ham Lake Dental Pa
17565 Central Ave Ne
Ham Lake
MN 55304
Ph: (763) 434-4188 |
NPI Details:
| NPI Number | 1205915881 |
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| Provider Enumeration Date | 11/03/2006 |
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| Last Update Date | 08/22/2020 |
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Medical Identifiers
Medical identifiers for Ham Lake Dental Pa such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1205915881 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 1223G0001X | Dentist - General Practice | D9362 (Minnesota) | Primary |
| 1223G0001X | Dentist - General Practice | D10416 (Minnesota) | Secondary |
| 1223G0001X | Dentist - General Practice | D10544 (Minnesota) | Secondary |
| 1223G0001X | Dentist - General Practice | D9466 (Minnesota) | Secondary |
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