Organization
LAKESHORE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMED M ALI DDS (OWNER)
(240) 765-4938
Entity
Organization
Contact information
Practice address
4700 CEDAR AVE S, MINNEAPOLIS, MN 55407-3634
(240) 765-4938
Mailing address
4700 CEDAR AVE S, MINNEAPOLIS, MN 55407-3634
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/21/2019
Last updated
03/21/2019
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