Organization
MINNESOTA STATE COLLEGES AND UNIVERSITIES
Active
Parent organization
MINNESOTA STATE COLLEGES AND UNIVERSITIES
Other names
Central Lakes College
Organization subpart
Yes
Provider details
NPI number
Legal business name
MINNESOTA STATE COLLEGES AND UNIVERSITIES
Authorized official
DR. LARRY LUNDBLAD (PRESIDENT)
(218) 855-8000
Entity
Organization
Contact information
Practice address
501 W COLLEGE DR, BRAINERD, MN 56401-3904
(218) 855-8000
Mailing address
501 W COLLEGE DR, BRAINERD, MN 56401-3904
(218) 855-8000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
MN
Other
Enumeration date
02/22/2008
Last updated
07/21/2022
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