| NPI | 1699204172 |
|---|---|
| Doing Business As | WEST LAKES DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE LYNN MINER President 612-387-5009 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MN D11974) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2017-06-08 |