| Lake Family Dental | |
|
307 South State Ave Warroad MN 56763-0490 | |
| (218) 386-1048 | |
| (218) 386-1049 |
| Full Name | Lake Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 307 South State Ave, Warroad, Minnesota |
| Authorized Official Name and Position | Kathy Ann Thiele (CORPORATE SECRETARY) |
| Authorized Official Contact | 2183861048 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Family Dental Po Box 490 Warroad MN 56763-0490 Ph: (218) 386-1048 | Lake Family Dental 307 South State Ave Warroad MN 56763-0490 Ph: (218) 386-1048 |
| NPI Number | 1497745400 |
|---|---|
| Provider Enumeration Date | 10/21/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497745400 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 9514 (Minnesota) | Primary |
Northern Lights Family Dentistry,pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 603 Emily Ave. Nw, Warroad, MN 56763 Phone: 218-386-2889 |