Organization
CROSSROADS OPTOMETRIC CLINIC, INC.
Active
Other names
Lakeside Family Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
LISA ANNE DAWSON-CLAUSEN OD (OWNER/OPTOMETRIST)
(952) 447-2020
Entity
Organization
Contact information
Practice address
16250 DULUTH AVE SE STE 100, PRIOR LAKE, MN 55372-2883
(952) 447-2020
(952) 447-2322
Mailing address
16250 DULUTH AVE SE STE 100, PRIOR LAKE, MN 55372-2883
(952) 447-2020
(952) 447-2322
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0001425
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2123989
MEDICA DME
MN
01
—
2223987
MEDICA
MN
01
—
3C258CR
BCBS DME
MN
01
—
4825
HEALTHPARTNERS
MN
01
—
51154HI
BCBS-MN
MN
01
—
92364
PREFERRED ONE
MN
Enumeration date
07/15/2006
Last updated
12/08/2020
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