Organization
DISTINCTIVE DENTAL SERVICES, PA
Active
Parent organization
DISTINCTIVE DENTAL SERVICES, PA
Other names
Howard Lake Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
DISTINCTIVE DENTAL SERVICES, PA
Authorized official
DR. MICHAEL JOHN THOENNES DDS (CEO)
(320) 485-4344
Entity
Organization
Contact information
Practice address
612 8TH AVE # 664, HOWARD LAKE, MN 55349-5137
(320) 543-2233
(320) 543-2368
Mailing address
612 8TH AVE # 664, HOWARD LAKE, MN 55349-5137
(320) 543-2233
(320) 543-2368
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D08971
MN
Other
Enumeration date
05/12/2008
Last updated
05/12/2008
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