| Elbow Lake Dentistry, Pllc | |
|
18 W Division St Elbow Lake MN 56531-4136 | |
| (218) 685-4710 | |
| Not Available |
| Full Name | Elbow Lake Dentistry, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 18 W Division St, Elbow Lake, Minnesota |
| Authorized Official Name and Position | Brady Elmer Weispfennig (SOLE MEMBER) |
| Authorized Official Contact | 3204910300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elbow Lake Dentistry, Pllc Po Box 26 Elbow Lake MN 56531-0026 Ph: (218) 685-4710 | Elbow Lake Dentistry, Pllc 18 W Division St Elbow Lake MN 56531-4136 Ph: (218) 685-4710 |
| NPI Number | 1740897156 |
|---|---|
| Provider Enumeration Date | 09/29/2020 |
| Last Update Date | 09/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740897156 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Elbow Lake Dental Center, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 18 Division St W, Po 1032, Elbow Lake, MN 56531 Phone: 218-685-4710 Fax: 218-685-6837 |