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1760107502
RICE LAKE DENTAL, P.A.
MAPLE GROVE, MN
NPI
1760107502
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Entity Type
Organization
Authorized Contact
DARREL HOWARD JOHNSRUD
President
612-385-6718
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center, Dental
Enumeration Date
2022-10-04
Last Update Date
2022-10-04
Business Address
RICE LAKE DENTAL, P.A.
13998 MAPLE KNOLL WAY STE 100
MAPLE GROVE, MN 55369-7004
Phone number: 763-420-5599
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Mailing Address
RICE LAKE DENTAL, P.A.
13998 MAPLE KNOLL WAY STE 100
MAPLE GROVE, MN 55369-7004
Phone number: 763-420-5599
Copy
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