| Eagle Lake Family Dentistry, P.a. | |
|
104 Plainview Street Box 97 Eagle Lake MN 56024 | |
| (507) 257-3800 | |
| (507) 257-3456 |
| Full Name | Eagle Lake Family Dentistry, P.a. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 104 Plainview Street, Eagle Lake, Minnesota |
| Authorized Official Name and Position | Bradley Allan Holmberg (PRESIDENT) |
| Authorized Official Contact | 5072573800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Lake Family Dentistry, P.a. 104 Plainview Street Box 97 Eagle Lake MN 56024 Ph: (507) 257-3800 | Eagle Lake Family Dentistry, P.a. 104 Plainview Street Box 97 Eagle Lake MN 56024 Ph: (507) 257-3800 |
| NPI Number | 1528138948 |
|---|---|
| Provider Enumeration Date | 11/09/2006 |
| Last Update Date | 02/09/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528138948 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Minnesota) | Primary |