Birch Lake Dental PA
NPI #1083853113 in White Bear Lake, Minnesota
Provider Information
- NPI Number
- 1083853113
- Entity Type
- Organization
- Organization Name
- Birch Lake Dental PA
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Feb 12, 2009
- Last Updated
- Feb 12, 2009
Practice Location
- Address
- 2641 WHITE BEAR PARKWAY
- City
- White Bear Lake
- State
- Minnesota
- ZIP Code
- 55110
- Phone
- (651) 429-0404
Authorized Official
- Name
- MRS. GEETHA J DAMODARAN, D.D.S.
- Title
- OWNER
- Phone
- (651) 429-0404
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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