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Organization

MINNESOTA DENTAL PROFESSIONALS, P.C.

Active
Parent organization
MINNESOTA DENTAL PROFESSIONALS, P.C.
Other names
Arbor Lakes Dental
Organization subpart
Yes

Provider details

NPI number
Legal business name
MINNESOTA DENTAL PROFESSIONALS, P.C.
Authorized official
TABATHA LEMKE (CREDENTIALING COORDINATOR)
(217) 540-6078
Entity
Organization

Contact information

Practice address
12000 ELM CREEK BLVD N STE 230, MAPLE GROVE, MN 55369-7075
(763) 251-5280
Mailing address
12000 ELM CREEK BLVD N STE 230, MAPLE GROVE, MN 55369-7075
(763) 251-5280

Taxonomy

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

Other

Enumeration date
04/01/2021
Last updated
04/01/2021
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