| Elbow Lake Dental Center, Inc. | |
|
18 Division St W Po 1032 Elbow Lake MN 56531 | |
| (218) 685-4710 | |
| (218) 685-6837 |
| Full Name | Elbow Lake Dental Center, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 18 Division St W, Elbow Lake, Minnesota |
| Authorized Official Name and Position | Orvin Jacob Leis (PRESIDENT) |
| Authorized Official Contact | 2186854710 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elbow Lake Dental Center, Inc. Po Box 1032 18 Division St W Elbow Lake MN 56531 Ph: (218) 685-4710 | Elbow Lake Dental Center, Inc. 18 Division St W Po 1032 Elbow Lake MN 56531 Ph: (218) 685-4710 |
| NPI Number | 1205904513 |
|---|---|
| Provider Enumeration Date | 12/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205904513 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8946 (Minnesota) | Primary |
Elbow Lake Dentistry, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 18 W Division St, Elbow Lake, MN 56531 Phone: 218-685-4710 |