Organization
CENTENNIAL LAKES DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUDY SLAVIK (OFFICE MANAGER)
(952) 831-2800
Entity
Organization
Contact information
Practice address
5851 DULUTH ST STE 218, GOLDEN VALLEY, MN 55422-3956
(763) 544-0121
(763) 544-2727
Mailing address
5851 DULUTH ST STE 218, GOLDEN VALLEY, MN 55422-3956
(763) 544-0121
(763) 544-2727
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/09/2008
Last updated
12/09/2008
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