Organization
LINDAHL FAMILY DENTAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL DEAN LINDAHL D.D.S. (DENTIST)
(651) 702-4200
Entity
Organization
Contact information
Practice address
1811 WEIR DR, SUITE #265, WOODBURY, MN 55125-2272
(651) 702-4200
(651) 702-0717
Mailing address
1811 WEIR DR, SUITE #265, WOODBURY, MN 55125-2272
(651) 702-4200
(651) 702-0717
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11031
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10D80LI
BCBS MN PROVIDER #
MN
01
—
707828
UNITED CONCORDIA TRICARE
MN
01
—
ZDB012
BCBS OF MASS PROVIDER #
MA
Enumeration date
02/21/2007
Last updated
08/22/2020
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