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Organization

LAKELAND DENTAL P.L.L.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOMINIC GAGNON DDS (PRESIDENT)
(320) 280-0466
Entity
Organization

Contact information

Practice address
917 1ST AVE SE, LONG PRAIRIE, MN 56347
(320) 732-6141
Mailing address
917 1ST AVE SE, LONG PRAIRIE, MN 56347-1448
(320) 732-6141

Taxonomy

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

Other

Enumeration date
08/02/2018
Last updated
08/04/2018
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