Organization
LEXINGTON DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD A WIBERG DDS (OWNER)
(651) 488-5557
Entity
Organization
Contact information
Practice address
1790 LEXINGTON AVE N, SUITE B, ROSEVILLE, MN 55113-6167
(651) 488-5557
(651) 488-0014
Mailing address
1790 LEXINGTON AVE N, SUITE B, ROSEVILLE, MN 55113-6167
(651) 488-5557
(651) 488-0014
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7141
MN
Other
Enumeration date
12/18/2006
Last updated
08/22/2020
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