Organization
LAKEVILLE ORTHODONTIC ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT R BOWLBY D.D.S. (DOCTOR)
(952) 435-4000
Entity
Organization
Contact information
Practice address
10440 185TH ST W, SUITE 300, LAKEVILLE, MN 55044-6678
(952) 435-4000
(952) 435-8001
Mailing address
10440 185TH ST W, SUITE 300, LAKEVILLE, MN 55044-6678
(952) 435-4000
(952) 435-8001
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D12240
MN
Other
Enumeration date
01/28/2008
Last updated
01/28/2008
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