Individual
NATHAN VANLAECKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
515 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0357
(612) 625-6444
Mailing address
1300 SAINT ANTHONY PKWY, MINNEAPOLIS, MN 55418-2160
(605) 868-2075
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
K685
MN
Other
Enumeration date
07/02/2018
Last updated
07/02/2018
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