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Organization
PRAIRIE LAKES FAMILY DENTISTRY
Active
Organization
PRAIRIE LAKES FAMILY DENTISTRY
Active
Other names
Prairie Lakes Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JON HEEZEN DDS (OWNER/DENTIST)
(507) 212-0002
Entity
Organization
Contact information
Practice address
212 3RD ST, TRACY, MN 56175-1214
(507) 212-0002
(507) 212-0020
Mailing address
PO BOX 1174, TRACY, MN 56175-0174
(507) 212-0002
(507) 212-0020
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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