Organization
AMUNDSON FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA KATHLEEN AMUNDSON DDS (OWNER/DENTIST)
(651) 459-3514
Entity
Organization
Contact information
Practice address
6939 PINE ARBOR DR S, STE 104, COTTAGE GROVE, MN 55016-4642
(651) 459-3514
(651) 459-4537
Mailing address
6939 PINE ARBOR DR S, STE 104, COTTAGE GROVE, MN 55016-4642
(651) 459-3514
(651) 459-4537
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D12460
MN
Other
Enumeration date
05/15/2013
Last updated
05/15/2013
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