Organization
DREAMHAVEN DENTAL SLEEP MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLINTON LAWRENCE ROBERTS DDS (OWNER DENTIST)
(218) 454-0523
Entity
Organization
Contact information
Practice address
13495 ELDER DR, SUITE 100, BAXTER, MN 56425-8763
(218) 454-0523
Mailing address
13495 ELDER DRIVE, SUITE 100, BAXTER, MN 56425
(218) 454-0523
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D10518
MN
Other
Enumeration date
11/22/2013
Last updated
11/22/2013
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