Interlachen Dental Associates

NPI #1174600621 in Edina, Minnesota

Provider Information

NPI Number
1174600621
Entity Type
Organization
Organization Name
Interlachen Dental Associates
Primary Specialty
Dentist - General Practice
Enumeration Date
Nov 1, 2006
Last Updated
Jan 12, 2012

Practice Location

Address
5101 VERNON AVENUE
Address 2
SUITE 1B
City
Edina
ZIP Code
55436
Phone
(952) 920-9579

Authorized Official

Name
DR. MICHAEL JOHN GITZEN, DDS
Title
PRESIDENT OWNER DOCTOR
Phone
(952) 920-9579

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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