Organization · Type 2 NPI
Fountain Lake Family Dental
Dental Clinic/Center · Albert Lea, MN
NPI number
1104435585
Active
Practice location
146 W Clark St
Albert Lea, MN 56007-2546
Fax (507) 373-4513
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
2 other providers at this address
Other dental clinic/center providers in Albert Lea
About NPI 1104435585
Fountain Lake Family Dental's National Provider Identifier is 1104435585, issued on Jul 30, 2020. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Albert Lea, MN. The record was last updated on Jul 30, 2020.