| Lake Superior Dental Associates | |
|
1225 E 1st St Duluth MN 55805-2402 | |
| (218) 728-6445 | |
| (218) 724-7003 |
| Full Name | Lake Superior Dental Associates |
|---|---|
| Speciality | Dentist |
| Location | 1225 E 1st St, Duluth, Minnesota |
| Authorized Official Name and Position | Robert G Ryan (PARTNER) |
| Authorized Official Contact | 2187286445 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Superior Dental Associates 1225 E 1st St Duluth MN 55805-2402 Ph: (218) 728-6445 | Lake Superior Dental Associates 1225 E 1st St Duluth MN 55805-2402 Ph: (218) 728-6445 |
| NPI Number | 1871672584 |
|---|---|
| Provider Enumeration Date | 11/03/2006 |
| Last Update Date | 10/30/2007 |
| Medicare PECOS PAC ID | 0345649554 |
|---|---|
| Medicare Enrollment ID | O20210520000645 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871672584 | NPI | - | NPPES |
| 820436 | Other | MN | UNITED CONCORDIA |
| 7B014FO | Other | MN | BCBS MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Robert G Ryan |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1952488132 PECOS PAC ID: 7012009616 Enrollment ID: I20070828000415 |
| Provider Name | Jeffrey Polzin |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1649687674 PECOS PAC ID: 2769788223 Enrollment ID: I20210520000863 |
| Provider Name | Paul D Bartlam |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1720167943 PECOS PAC ID: 0941500086 Enrollment ID: I20210520001807 |
| Provider Name | Meaghan E Morrell Huot |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1356661516 PECOS PAC ID: 2769746643 Enrollment ID: I20210520002010 |
| Provider Name | Seth Amadio |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1427369677 PECOS PAC ID: 3577796036 Enrollment ID: I20210520002517 |
| Provider Name | Robert Alexander Johnson |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1093200826 PECOS PAC ID: 9638413875 Enrollment ID: I20210520002594 |
| Provider Name | Ross Allen Anderson |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1891011748 PECOS PAC ID: 2567627409 Enrollment ID: I20210609002399 |
| Provider Name | Eric D Iwen |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1871723593 PECOS PAC ID: 2264832724 Enrollment ID: I20210621002461 |
| Provider Name | Melanie Sue Meier Buhr |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1639183726 PECOS PAC ID: 5597846105 Enrollment ID: I20210622002884 |
| Provider Name | Vanessa K Olson |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1942304407 PECOS PAC ID: 5092983932 Enrollment ID: I20220930000720 |
Dental Specialist Of Minnesota, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 324 W Superior St Ste 824, Duluth, MN 55802 Phone: 218-727-1182 | |
Richard W Oase Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 306 W Superior St, Suite 601, Duluth, MN 55802 Phone: 218-727-2349 Fax: 218-727-2531 | |
Blue Water Oral And Facial Surgery Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1000 E 1st St Ste 108, Duluth, MN 55805 Phone: 218-722-1854 Fax: 218-722-6424 | |
Mount Royal Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1624 Woodland Ave, Duluth, MN 55803 Phone: 218-464-5222 Fax: 218-464-5229 | |
Pdg, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 906 Woodland Ave, Duluth, MN 55812 Phone: 218-606-1040 Fax: 218-606-1060 | |
Chester Creek Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1324 E 1st St, Duluth, MN 55805 Phone: 218-724-1332 Fax: 218-724-2184 | |
Daniel J Loban Dds Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1011 E Central Entrance, Duluth, MN 55811 Phone: 218-722-1715 Fax: 218-727-3217 |