Organization
SOUTH LAKE CLINIC, P.A.
Active
Other names
South Lake Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE T DOBRIN M.D. (OWNER/MEDICAL DIRECTOR)
(952) 401-8300
Entity
Organization
Contact information
Practice address
17705 HUTCHINS DR, SUITE 101, MINNETONKA, MN 55345-4145
(952) 401-8300
(952) 401-8243
Mailing address
17705 HUTCHINS DR, SUITE 101, MINNETONKA, MN 55345-4145
(952) 401-8300
(952) 401-8243
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
556
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091010400
—
MN
01
—
16623SO
BCBS
MN
Enumeration date
03/15/2006
Last updated
09/23/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up