Forest Lake Orthodontics
NPI #1023452638 in Forest Lake, Minnesota
Provider Information
- NPI Number
- 1023452638
- Entity Type
- Organization
- Organization Name
- Forest Lake Orthodontics
- Primary Specialty
- Dentist - Orthodontics and Dentofacial Orthopedics
- Enumeration Date
- Apr 25, 2013
- Last Updated
- Apr 25, 2013
Practice Location
- Address
- 25 LAKE ST N
- Address 2
- SUITE 135
- City
- Forest Lake
- State
- Minnesota
- ZIP Code
- 55025-2535
- Phone
- (651) 464-1151
Authorized Official
- Name
- DR. TRAVIS W WILLE, DDS, MS
- Title
- PRESIDENT/ORTHODONTIST
- Phone
- (651) 464-1151
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics |
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