Organization
LAKEVIEW FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW JAMES CARRELL D.D.S. (DENTIST)
(612) 202-9749
Entity
Organization
Contact information
Practice address
14475 FOREST BLVD N, HUGO, MN 55038-7461
(651) 426-8088
Mailing address
14475 FOREST BLVD N, HUGO, MN 55038-7461
(651) 426-8088
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D12901
MN
Other
Enumeration date
11/25/2014
Last updated
12/10/2014
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