| Land Of Lakes Endodontics Pa | |
|
2850 Curve Crest Blvd W Ste 115 Stillwater MN 55082-6101 | |
| (651) 439-8764 | |
| (651) 439-9660 |
| Full Name | Land Of Lakes Endodontics Pa |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 2850 Curve Crest Blvd W Ste 115, Stillwater, Minnesota |
| Authorized Official Name and Position | Matthew M Grau (OWNER) |
| Authorized Official Contact | 6514398764 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Land Of Lakes Endodontics Pa 2850 Curve Crest Blvd W Ste 115 Stillwater MN 55082-4073 Ph: (651) 439-8764 | Land Of Lakes Endodontics Pa 2850 Curve Crest Blvd W Ste 115 Stillwater MN 55082-6101 Ph: (651) 439-8764 |
| NPI Number | 1710108022 |
|---|---|
| Provider Enumeration Date | 05/02/2007 |
| Last Update Date | 02/16/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710108022 | NPI | - | NPPES |
| 237L1LA | Other | MN | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 11312 (Minnesota) | Primary |
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