Organization
LIBBY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAYLA LIBBY DDS (DENTIST)
(651) 278-8662
Entity
Organization
Contact information
Practice address
20 LAKE ST N STE 205, FOREST LAKE, MN 55025-2511
(651) 464-3052
Mailing address
20 LAKE ST N STE 205, FOREST LAKE, MN 55025-2511
(651) 464-3052
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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