Elbow Lake Dental Center, Inc.
NPI #1205904513 in Elbow Lake, Minnesota
Provider Information
- NPI Number
- 1205904513
- Entity Type
- Organization
- Organization Name
- Elbow Lake Dental Center, Inc.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Dec 4, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 18 DIVISION ST W
- Address 2
- PO 1032
- City
- Elbow Lake
- State
- Minnesota
- ZIP Code
- 56531
- Phone
- (218) 685-4710
Authorized Official
- Name
- DR. ORVIN JACOB LEIS, DDS
- Title
- PRESIDENT
- Phone
- (218) 685-4710
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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|---|---|
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