| NPI | 1508984410 |
|---|---|
| Doing Business As | LAKES MOBILE DENTAL |
| Entity Type | Organization |
| Authorized Contact | REBECCA LEIGH WILSON President 218-831-3131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D12159) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2008-04-10 |