Organization
CLD - BROOKLYN PARK MN, LLC
Active
Other names
Clear Lakes Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID PARK DMD (CEO / OWNER)
(651) 444-9644
Entity
Organization
Contact information
Practice address
7710 BROOKLYN BLVD FL 1, BROOKLYN PARK, MN 55443-2979
(651) 292-9331
Mailing address
7710 BROOKLYN BLVD FL 1, BROOKLYN PARK, MN 55443-2979
(651) 292-9331
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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