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 |