Organization
ROUND LAKE DENTAL P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS RICHARD SWENSON DDS (PRESIDENT)
(763) 427-0285
Entity
Organization
Contact information
Practice address
13841 ROUND LAKE BLVD NW, ANDOVER, MN 55304-3664
(763) 427-0285
(763) 576-0156
Mailing address
13841 ROUND LAKE BLVD NW, ANDOVER, MN 55304-3664
(763) 427-0285
(763) 576-0156
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D10339
MN
Other
Enumeration date
03/14/2007
Last updated
08/22/2020
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