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Organization
WARROAD FAMILY DENTISTRY, LTD
Active
Organization
WARROAD FAMILY DENTISTRY, LTD
Active
Other names
Lake Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY ANN THIELE (CORPORATE SECRETARY)
(218) 386-1048
Entity
Organization
Contact information
Practice address
307 SOUTH STATE AVE, WARROAD, MN 56763-0490
(218) 386-1048
(218) 386-1049
Mailing address
PO BOX 490, WARROAD, MN 56763-0490
(218) 386-1048
(218) 386-1049
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9514
MN
Other
Enumeration date
10/21/2005
Last updated
08/22/2020
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