| Lakeville Dental Associates, Pa | |
|
20171 Icenic Trl Lakeville MN 55044-7708 | |
| (952) 469-3300 | |
| Not Available |
| Full Name | Lakeville Dental Associates, Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 20171 Icenic Trl, Lakeville, Minnesota |
| Authorized Official Name and Position | Rose A Harrison (MANAGER) |
| Authorized Official Contact | 9524693300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeville Dental Associates, Pa 20171 Icenic Trl Lakeville MN 55044-7708 Ph: (952) 469-3300 | Lakeville Dental Associates, Pa 20171 Icenic Trl Lakeville MN 55044-7708 Ph: (952) 469-3300 |
| NPI Number | 1053614867 |
|---|---|
| Provider Enumeration Date | 12/16/2010 |
| Last Update Date | 10/17/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053614867 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D12108 (Minnesota) | Primary |
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