Chisago Lakes Dental Services LLC

NPI #1306255070 in Lindstrom, Minnesota

Provider Information

NPI Number: 1306255070
Entity Type: Organization
Organization Name: Chisago Lakes Dental Services LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 7, 2014
Last Updated: Aug 7, 2014

Practice Location

Address: 12745 N 1ST AVE
City: Lindstrom
State: Minnesota
ZIP Code: 55045-9585
Phone: (763) 360-1465

Authorized Official

Name: MR. MICHAEL HURSH, DDS
Title: OWNER
Phone: (763) 360-1465

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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