| Fountain Lake Family Dental | |
|
146 W Clark St Albert Lea MN 56007-2546 | |
| (507) 373-3323 | |
| (507) 373-4513 |
| Full Name | Fountain Lake Family Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 146 W Clark St, Albert Lea, Minnesota |
| Authorized Official Name and Position | Karisa Lehmann (OFFICE MANAGER) |
| Authorized Official Contact | 5073733323 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fountain Lake Family Dental 146 W Clark St Albert Lea MN 56007-2546 Ph: (507) 373-3323 | Fountain Lake Family Dental 146 W Clark St Albert Lea MN 56007-2546 Ph: (507) 373-3323 |
| NPI Number | 1104435585 |
|---|---|
| Provider Enumeration Date | 07/30/2020 |
| Last Update Date | 07/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104435585 | NPI | - | NPPES |
| D13630 | Other | MN | MINNESOTA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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