Organization
GRAND RAPIDS DENTAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN LAMKE (OFFICE MANAGER)
(218) 326-3438
Entity
Organization
Contact information
Practice address
220 SE 21ST ST, GRAND RAPIDS, MN 55744-4268
(218) 326-3438
Mailing address
220 SE 21ST ST, GRAND RAPIDS, MN 55744-4268
(218) 326-3438
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T65577
UPIN
—
Enumeration date
03/04/2020
Last updated
03/04/2020
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