Organization
CENTENNIAL LAKES ORTHODONTICS PLLC
Active
Organization
CENTENNIAL LAKES ORTHODONTICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN COLBY (OWNER)
(952) 831-1324
Entity
Organization
Contact information
Practice address
7373 FRANCE AVE S STE 400, EDINA, MN 55435-4549
(952) 831-1324
Mailing address
7373 FRANCE AVE S STE 400, EDINA, MN 55435-4549
(952) 831-1324
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
07/09/2020
Last updated
07/09/2020
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