| NPI | 1104400845 |
|---|---|
| Doing Business As | HAM LAKE DENTAL PLLC |
| Entity Type | Organization |
| Authorized Contact | ALEX SHNAYDRUK Dentist 952-261-4307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2021-05-10 |