Organization
PRAIRIE LAKES FAMILY DENTISTRY
Active
Other names
Prairie Lakes Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JON HEEZEN DDS (OWNER/DENTIST)
(507) 212-0002
Entity
Organization
Contact information
Practice address
212 3RD ST, TRACY, MN 56175-1214
(507) 212-0002
(507) 212-0020
Mailing address
PO BOX 1174, TRACY, MN 56175-0174
(507) 212-0002
(507) 212-0020
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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