Organization
LAKE MINNETONKA ORTHDONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DAWN J RENNER CPA (ACCOUNTANT)
(952) 933-8444
Entity
Organization
Contact information
Practice address
11601 MINNETONKA MILLS RD, MINNETONKA, MN 55305-5161
(952) 938-1443
Mailing address
11601 MINNETONKA MILLS RD, MINNETONKA, MN 55305-5161
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
7094
MN
Other
Enumeration date
12/20/2006
Last updated
08/22/2020
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