| NPI | 1568648871 |
|---|---|
| Doing Business As | LAKE NOKOMIS DENTAL |
| Entity Type | Organization |
| Authorized Contact | DAN M PROESCHEL Owner 612-729-6150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MN D7926) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2008-01-16 |