Great Lakes Endodontics
NPI #1104255371 in Hermantown, Minnesota
Provider Information
- NPI Number
- 1104255371
- Entity Type
- Organization
- Organization Name
- Great Lakes Endodontics
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Nov 7, 2013
- Last Updated
- Nov 7, 2013
Practice Location
- Address
- 4815 W ARROWHEAD RD
- City
- Hermantown
- State
- Minnesota
- ZIP Code
- 55811-4004
- Phone
- (218) 772-0772
Authorized Official
- Name
- DR. MARK TERRANCE PHILLIPS, DDS
- Title
- DENTIST
- Phone
- (651) 528-0240
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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