Organization
LAKES AREA MOBILE SMILES, INC
Active
Other names
Lakes Mobile Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REBECCA LEIGH WILSON RDH (PRESIDENT)
(218) 831-3131
Entity
Organization
Contact information
Practice address
22187 STATE HIGHWAY 6, DEERWOOD, MN 56444-6279
(218) 831-3131
(612) 235-3391
Mailing address
22187 STATE HIGHWAY 6, DEERWOOD, MN 56444-6279
(218) 831-3131
(612) 235-3391
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12159
MN
Other
Enumeration date
03/27/2007
Last updated
04/10/2008
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