| NPI | 1235746058 |
|---|---|
| Doing Business As | LAKE MINNETONKA FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | ROBYN THEISEN VP Of Operations 952-250-3060 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2020-09-25 |