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101 Roosevelt Ave Detroit Lakes MN 56501-2626 | |
| (218) 847-8765 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 101 Roosevelt Ave, Detroit Lakes, Minnesota |
| Authorized Official Name and Position | Luke M Sailer (PRACTICE OWNER) |
| Authorized Official Contact | 2185350055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
44509 E Little Mcdonald Dr Perham MN 56573-8640 Ph: (218) 535-0055 | 101 Roosevelt Ave Detroit Lakes MN 56501-2626 Ph: (218) 847-8765 |
| NPI Number | 1629819222 |
|---|---|
| Provider Enumeration Date | 06/05/2024 |
| Last Update Date | 06/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629819222 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |