| NPI | 1861869265 |
|---|---|
| Doing Business As | LONE OAK DENTAL |
| Entity Type | Organization |
| Authorized Contact | BRADLEY DAVID JORDAN Owner 612-532-2094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: SD 284) |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2022-01-11 |