Organization
LAKESHORE FAMILY DENTISTRY PA
Active
Other names
A.K.A. Kenyon, Wright & Kron DDS PA
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JONNI D DELGRECO (OFFICE MANAGER)
(651) 429-3348
Entity
Organization
Contact information
Practice address
4706 BANNING AVE, WHITE BEAR LAKE, MN 55110
(651) 429-3348
(651) 429-3945
Mailing address
4706 BANNING AVE, WHITE BEAR LAKE, MN 55110
(651) 429-3348
(651) 429-3945
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
10994
MN
1223G0001X
General Practice Dentistry
Primary
8263
MN
1223G0001X
General Practice Dentistry
9253
MN
Other
Enumeration date
08/17/2006
Last updated
08/07/2008
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