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Organization
LAKELAND DENTAL P.L.L.C.
Active
Organization
LAKELAND DENTAL P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIC GAGNON DDS (PRESIDENT)
(320) 280-0466
Entity
Organization
Contact information
Practice address
917 1ST AVE SE, LONG PRAIRIE, MN 56347
(320) 732-6141
Mailing address
917 1ST AVE SE, LONG PRAIRIE, MN 56347-1448
(320) 732-6141
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/02/2018
Last updated
08/04/2018
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