Organization
LAKE VALLEY DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHNATHAN WERMERS DMD (DENTIST)
(605) 770-8667
Entity
Organization
Contact information
Practice address
1511 BROADWAY, WHEATON, MN 56296-1040
(320) 563-4800
Mailing address
1511 BROADWAY, WHEATON, MN 56296-1040
(320) 563-4800
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/28/2021
Last updated
08/28/2021
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