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Individual

DR. LISA KATHLEEN AMUNDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
6939 PINE ARBOR DR S, SUITE A104, COTTAGE GROVE, MN 55016-4580
(651) 459-3514
Mailing address
6939 PINE ARBOR DR S, SUITE A104, COTTAGE GROVE, MN 55016-4580
(651) 459-3514

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12460
MN

Other

Enumeration date
10/09/2007
Last updated
10/09/2007
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