| Lake Street Family Dental Pa | |
|
119 Lake St S Suite 1 Mora MN 55051-1576 | |
| (320) 679-2435 | |
| Not Available |
| Full Name | Lake Street Family Dental Pa |
|---|---|
| Speciality | Dentist |
| Location | 119 Lake St S, Mora, Minnesota |
| Authorized Official Name and Position | Steven Nelson Holcombe (PRESIDENT) |
| Authorized Official Contact | 7633506234 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Street Family Dental Pa 10799 251st Ave Nw Zimmerman MN 55398-4558 Ph: (763) 350-6234 | Lake Street Family Dental Pa 119 Lake St S Suite 1 Mora MN 55051-1576 Ph: (320) 679-2435 |
| NPI Number | 1083096085 |
|---|---|
| Provider Enumeration Date | 06/25/2015 |
| Last Update Date | 06/25/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083096085 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D13567 (Minnesota) | Primary |
Haasken Dental, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 Forest Ave E, Mora, MN 55051 Phone: 320-679-1010 | |
Mora Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 547 Union St S, Mora, MN 55051 Phone: 320-679-2147 Fax: 320-679-2101 | |
James M. Williams, D.d.s., P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 620 Union St S, Mora, MN 55051 Phone: 320-679-3073 | |
Dr. James Knutson Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 119 Lake St S, Suite 1, Mora, MN 55051 Phone: 320-679-2435 Fax: 320-679-0401 | |
Mora Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 547 Union St S, Mora, MN 55051 Phone: 320-679-2147 Fax: 320-679-2101 |