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Organization
ELBOW LAKE DENTAL CENTER, INC.
Active
Organization
ELBOW LAKE DENTAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ORVIN JACOB LEIS DDS (PRESIDENT)
(218) 685-4710
Entity
Organization
Contact information
Practice address
18 DIVISION ST W, PO 1032, ELBOW LAKE, MN 56531
(218) 685-4710
(218) 685-6837
Mailing address
PO BOX 1032, 18 DIVISION ST W, ELBOW LAKE, MN 56531
(218) 685-4710
(218) 685-6837
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8946
MN
Other
Enumeration date
12/04/2006
Last updated
08/22/2020
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