| Lake Area Dental | |
|
4801 Highway 61 N Ste 301 White Bear Lake MN 55110-2753 | |
| (651) 762-8474 | |
| Not Available |
| Full Name | Lake Area Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4801 Highway 61 N Ste 301, White Bear Lake, Minnesota |
| Authorized Official Name and Position | Jordan Dittberner (DENTIST) |
| Authorized Official Contact | 6513081177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Area Dental 140 Wildwood Ct Mahtomedi MN 55115-4200 Ph: (651) 308-1177 | Lake Area Dental 4801 Highway 61 N Ste 301 White Bear Lake MN 55110-2753 Ph: (651) 762-8474 |
| NPI Number | 1265248173 |
|---|---|
| Provider Enumeration Date | 12/05/2024 |
| Last Update Date | 12/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265248173 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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