Individual
SANDRA LARA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
520 MAIN ST, HAWLEY, MN 56549-4726
(218) 483-1339
Mailing address
PO BOX 849, 520 MAIN STREET, HAWLEY, MN 56549-0849
(218) 483-1339
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11832
MN
Other
Enumeration date
04/06/2006
Last updated
07/08/2007
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