Organization
ELBOW LAKE DENTAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ORVIN JACOB LEIS DDS (PRESIDENT)
(218) 685-4710
Entity
Organization
Contact information
Practice address
18 DIVISION ST W, PO 1032, ELBOW LAKE, MN 56531
(218) 685-4710
(218) 685-6837
Mailing address
PO BOX 1032, 18 DIVISION ST W, ELBOW LAKE, MN 56531
(218) 685-4710
(218) 685-6837
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8946
MN
Other
Enumeration date
12/04/2006
Last updated
08/22/2020
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