| Lakeland Dental P.l.l.c. | |
| 
					917 1st Ave Se Long Prairie MN 56347  | |
| (320) 732-6141 | |
| Not Available | 
| Full Name | Lakeland Dental P.l.l.c. | 
|---|---|
| Speciality | Dentist - General Practice | 
| Location | 917 1st Ave Se, Long Prairie, Minnesota | 
| Authorized Official Name and Position | Dominic Gagnon (PRESIDENT) | 
| Authorized Official Contact | 3202800466 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Lakeland Dental P.l.l.c. 917 1st Ave Se Long Prairie MN 56347-1448 Ph: (320) 732-6141  | Lakeland Dental P.l.l.c. 917 1st Ave Se Long Prairie MN 56347 Ph: (320) 732-6141  | 
| NPI Number | 1598243438 | 
|---|---|
| Provider Enumeration Date | 08/02/2018 | 
| Last Update Date | 08/04/2018 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1598243438 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary | 
Prairie Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 220 Lake St S Ste 103, Long Prairie, MN 56347 Phone: 320-533-0240  | |
Long Prairie Dental Clinic Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 917 1st Ave Se, Long Prairie, MN 56347 Phone: 320-732-6141 Fax: 320-732-6543  |