| NPI | 1891885000 |
|---|---|
| Doing Business As | LAKE ELMO DENTAL |
| Entity Type | Organization |
| Authorized Contact | DOUGLAS STEVEN WOLFF Owner Dentist 651-777-0210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2020-08-22 |