Organization
MOORE LAKE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA MURRAY PEREZ D.D.S. (OWNER)
(612) 414-2182
Entity
Organization
Contact information
Practice address
6230 HIGHWAY 65 NE, SUITE 105, FRIDLEY, MN 55432-5107
(763) 571-5497
Mailing address
6230 HIGHWAY 65 NE, SUITE 105, FRIDLEY, MN 55432-5107
(763) 571-5497
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10520
MN
Other
Enumeration date
02/10/2015
Last updated
02/10/2015
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