Organization
NORTHERN LAKES DENTAL - RIVERFRONT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATIE SUE BAGLO (ADMINISTRATIVE ASSISTANT)
(218) 736-4000
Entity
Organization
Contact information
Practice address
124 E LINCOLN AVE, FERGUS FALLS, MN 56537-2217
(218) 736-5627
(218) 736-6955
Mailing address
1108 WESTERN AVE, FERGUS FALLS, MN 56537-4808
(218) 736-4000
(218) 736-0766
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/05/2019
Last updated
12/05/2019
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