Northern Lakes Dental, Ltd.
NPI #1003035775 in Fergus Falls, Minnesota
Provider Information
- NPI Number
- 1003035775
- Entity Type
- Organization
- Organization Name
- Northern Lakes Dental, Ltd.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Apr 24, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1108 WESTERN AVE
- City
- Fergus Falls
- State
- Minnesota
- ZIP Code
- 56537-4808
- Phone
- (218) 736-4000
Authorized Official
- Name
- SCOTT ALAN WAGNILD, D. D. S.
- Title
- PRESIDENT
- Phone
- (218) 736-4000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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