Organization
KIERSTEN MASELLO DDS PLLC
Active
Other names
Crosslake Dental Center, PA
Organization subpart
No
Provider details
NPI number
Authorized official
KIERSTEN MICAEL BOEHM MASELLO DDS (DENTIST)
(651) 587-6846
Entity
Organization
Contact information
Practice address
13832 RIVERWOOD LN, CROSSLAKE, MN 56442-2823
(218) 692-4849
Mailing address
20438 WHITETAIL DR, BRAINERD, MN 56401-5382
(651) 587-6846
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/03/2022
Last updated
03/03/2022
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