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Organization

GLACIAL LAKES DENTAL, PLLP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DAWN RENAE PLATT (OFFICE MANAGER)
(320) 235-7742
Entity
Organization

Contact information

Practice address
509 16TH AVE SW, WILLMAR, MN 56201-4118
(320) 235-7742
(320) 235-4045
Mailing address
509 16TH AVE SW, WILLMAR, MN 56201-4118
(320) 235-7742
(320) 235-4045

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
03/17/2011
Last updated
03/17/2011
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