Organization · Type 2 NPI

Prior Lake

Dental Clinic/Center · Prior Lake, MN

NPI number 1083131643 Active

Practice location

14120 Commerce Ave, Suite #300
Prior Lake, MN 55372-5537

Call (952) 447-1080 Map

Fax (952) 447-0376

Mailing address

14120 Commerce Ave NE Ste 300
Prior Lake, MN 55372-1503

Specialties and licenses

TaxonomyCodeLicense
Dental Clinic/Center Primary 261QD0000XD13230 (MN)

Dental Clinic/Center: Definition to come...

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About NPI 1083131643

Prior Lake's National Provider Identifier is 1083131643, issued on Aug 24, 2017. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Prior Lake, MN. The record was last updated on Jul 21, 2022.