Organization
WILLMAR DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN GLANCEY (CHIEF FINANCIAL OFFICER)
(651) 539-7200
Entity
Organization
Contact information
Practice address
1604 1ST ST. S, SUITE 140, WILLMAR, MN 56201-2276
(320) 231-5315
(320) 231-5303
Mailing address
3200 LABORE RD., SUITE 104, VADNAIS HEIGHTS, MN 55110-5186
(651) 539-7200
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
243833000
—
MN
Enumeration date
01/29/2007
Last updated
01/07/2026
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