| Lake Minnetonka Orthdontics | |
|
11601 Minnetonka Mills Rd Minnetonka MN 55305-5161 | |
| (952) 938-1443 | |
| Not Available |
| Full Name | Lake Minnetonka Orthdontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 11601 Minnetonka Mills Rd, Minnetonka, Minnesota |
| Authorized Official Name and Position | Dawn J Renner (ACCOUNTANT) |
| Authorized Official Contact | 9529338444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Minnetonka Orthdontics 11601 Minnetonka Mills Rd Minnetonka MN 55305-5161 Ph: () - | Lake Minnetonka Orthdontics 11601 Minnetonka Mills Rd Minnetonka MN 55305-5161 Ph: (952) 938-1443 |
| NPI Number | 1700940343 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700940343 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 7094 (Minnesota) | Primary |
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