| Long Lake Dental | |
|
1870 W Wayzata Blvd Long Lake MN 55356-9491 | |
| (952) 473-7151 | |
| (952) 475-1539 |
| Full Name | Long Lake Dental |
|---|---|
| Speciality | Dentist |
| Location | 1870 W Wayzata Blvd, Long Lake, Minnesota |
| Authorized Official Name and Position | Douglas J. Mcnaught (DOCTOR/OWNER) |
| Authorized Official Contact | 9524737151 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Long Lake Dental Po Box 695 Long Lake MN 55356-0695 Ph: (952) 473-7151 | Long Lake Dental 1870 W Wayzata Blvd Long Lake MN 55356-9491 Ph: (952) 473-7151 |
| NPI Number | 1053585653 |
|---|---|
| Provider Enumeration Date | 04/15/2008 |
| Last Update Date | 07/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053585653 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D9985 (Minnesota) | Primary |
Lakeside Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1880 W Wayzata Blvd, Long Lake, MN 55356 Phone: 952-475-0989 Fax: 952-475-2053 |