| Clear Lakes Dental - Richfield | |
|
704 W 66th St Richfield MN 55423-2203 | |
| (612) 915-0015 | |
| (612) 915-0015 |
| Full Name | Clear Lakes Dental - Richfield |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 704 W 66th St, Richfield, Minnesota |
| Authorized Official Name and Position | David Park (CEO/PRESIDENT/OWNER) |
| Authorized Official Contact | 6514449644 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clear Lakes Dental - Richfield 704 W 66th St Richfield MN 55423-2203 Ph: (612) 915-0015 | Clear Lakes Dental - Richfield 704 W 66th St Richfield MN 55423-2203 Ph: (612) 915-0015 |
| NPI Number | 1932956919 |
|---|---|
| Provider Enumeration Date | 05/06/2024 |
| Last Update Date | 05/06/2024 |
| Certification Date | 05/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932956919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Primary |
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