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Organization

BYRON DENTAL GROUP PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LORI LEE STACKHOUSE (OFFICE MANAGER)
(507) 775-6445
Entity
Organization

Contact information

Practice address
21 NE FRONTAGE RD., BYRON, MN 55920
(507) 775-6445
(507) 775-6446
Mailing address
P.O. BOX 37, 21 NE FRONTAGE RD.,, BYRON, MN 55920
(507) 775-6445
(507) 775-6446

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
10/16/2009
Last updated
12/11/2019
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