| NPI | 1780453589 |
|---|---|
| Doing Business As | PRAIRIE LAKES FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JON HEEZEN Owner/Dentist 507-212-0002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-12-21 |
| Last Update Date | 2023-12-21 |