| Lakeville Modern Dentistry, Pllc | |
|
17746 Kenwood Trl Lakeville MN 55044-9454 | |
| (920) 723-8420 | |
| Not Available |
| Full Name | Lakeville Modern Dentistry, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 17746 Kenwood Trl, Lakeville, Minnesota |
| Authorized Official Name and Position | Eric M Bender (PRESIDENT) |
| Authorized Official Contact | 9207238420 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeville Modern Dentistry, Pllc 17746 Kenwood Trl Lakeville MN 55044-9454 Ph: (952) 388-1778 | Lakeville Modern Dentistry, Pllc 17746 Kenwood Trl Lakeville MN 55044-9454 Ph: (920) 723-8420 |
| NPI Number | 1992403919 |
|---|---|
| Provider Enumeration Date | 02/20/2023 |
| Last Update Date | 04/22/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992403919 | NPI | - | NPPES |
| 1194394288 | Other | NPI TYPE I |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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