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Organization

TAXPAYER NAME: MORGANDIA D.C./DOING BUSINESS AS CITY IF LAKES DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAIMIE HOILAND DDS (DENTIST, OWNER)
(612) 823-1816
Entity
Organization

Contact information

Practice address
5524 NICOLLET AVE., MINNEAPOLIS, MN 55419
(612) 823-1816
Mailing address
5524 NICOLLET AVE., MINNEAPOLIS, MN 55419
(612) 823-1816

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
06/05/2023
Last updated
06/05/2023
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