Glen Lake Dental Associates, P.a.
NPI #1003062084 in Minnetonka, Minnesota
Provider Information
- NPI Number
- 1003062084
- Entity Type
- Organization
- Organization Name
- Glen Lake Dental Associates, P.a.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Aug 11, 2008
- Last Updated
- Aug 11, 2008
Practice Location
- Address
- 14418 EXCELSIOR BLVD
- City
- Minnetonka
- State
- Minnesota
- ZIP Code
- 55345-5820
- Phone
- (952) 935-5212
Authorized Official
- Name
- KENT CASSIDY, D.D.S.
- Title
- PRESIDENT
- Phone
- (952) 935-5212
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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