Big Lake Dental, PA

NPI #1518141548 in Big Lake, Minnesota

Provider Information

NPI Number
1518141548
Entity Type
Organization
Organization Name
Big Lake Dental, PA
Primary Specialty
Dentist - General Practice
Enumeration Date
Dec 27, 2007
Last Updated
Dec 27, 2007

Practice Location

Address
16991 198TH AVENUE NW
ZIP Code
55309-0249
Phone
(763) 263-6350

Authorized Official

Name
DR. ROGER J BROMAGHIM, D.D.S.
Title
OWNER
Phone
(763) 263-6350

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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