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Organization
HAM LAKE DENTAL PLLC
Active
Organization
HAM LAKE DENTAL PLLC
Active
Other names
Ham Lake Dental PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEX SHNAYDRUK DDS (DENTIST)
(952) 261-4307
Entity
Organization
Contact information
Practice address
16220 ABERDEEN ST NE STE A1, ANDOVER, MN 55304-5421
(763) 415-7831
Mailing address
16220 ABERDEEN ST NE STE A1, ANDOVER, MN 55304-5421
(763) 415-7831
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/10/2021
Last updated
05/10/2021
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