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Organization

LAKEWOOD DENTAL - PINE ISLAND LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GENIE KUBLE (ACCESS MANAGER)
(920) 450-0157
Entity
Organization

Contact information

Practice address
232 S MAIN ST, PINE ISLAND, MN 55963-9190
(715) 833-8755
Mailing address
232 S MAIN ST, PINE ISLAND, MN 55963-9190
(715) 833-8755

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
04/02/2024
Last updated
04/02/2024
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