| Isla Pllc | |
|
4754 Washington Sq White Bear Lake MN 55110-3257 | |
| (651) 353-6652 | |
| Not Available |
| Full Name | Isla Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4754 Washington Sq, White Bear Lake, Minnesota |
| Authorized Official Name and Position | Tracy Anderson (DIRECTOR) |
| Authorized Official Contact | 6513536652 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Isla Pllc 7810 Saint Croix Trail Ln S Hastings MN 55033-9737 Ph: (651) 353-6652 | Isla Pllc 4754 Washington Sq White Bear Lake MN 55110-3257 Ph: (651) 353-6652 |
| NPI Number | 1720621451 |
|---|---|
| Provider Enumeration Date | 10/25/2019 |
| Last Update Date | 10/25/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720621451 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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