Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LAKE STREET FAMILY DENTAL PA
Active OrganizationLAKE STREET FAMILY DENTAL PA is a Dentist organization located in MORA, Minnesota. NPI 1083096085 is currently active in the NPPES registry. Verify at CMS.
Dentist · MORA, MN
Registration Details
- NPI Number
- 1083096085
- Provider Type
- Organization
- NPI Issued
- Jun 25, 2015 (11.138408568738 yrs)
- Last Updated
- Jun 25, 2015
- License
-
D13567 (MN)
Practice Information
- Address
-
119 LAKE ST SSUITE 1MORA, MN, 550511576Browse MN providers · Browse ZIP 55051
- Phone
- 3206792435
- Primary Specialty
-
Dentist
122300000X
Other Dentist Organizations in MORA, MN
| Name | NPI |
|---|---|
| DR. JAMES KNUTSON | 1487095220 |
| MORA DENTAL CENTER LLC | 1144760158 |
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.