Organization
GLEN LAKE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTY TARAN DDS (DENTIST)
(952) 935-5212
Entity
Organization
Contact information
Practice address
14421 EXCELSIOR BLVD, MINNETONKA, MN 55345-5821
(952) 935-5212
(952) 935-1391
Mailing address
14421 EXCELSIOR BLVD, MINNETONKA, MN 55345-5821
(952) 935-5212
(952) 935-1391
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/14/2024
Last updated
06/14/2024
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