Organization
BLOOMINGTON LAKE DENTAL CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SAUNDRA ANN ROHRER (MANAGER)
(612) 729-2393
Entity
Organization
Contact information
Practice address
3042 BLOOMINGTON AVE, MINNEAPOLIS, MN 55407-1716
(612) 729-2393
(612) 729-2395
Mailing address
3042 BLOOMINGTON AVE, MINNEAPOLIS, MN 55407-1716
(612) 729-2393
(612) 729-2395
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11528
MN
Other
Enumeration date
10/04/2006
Last updated
08/22/2020
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