Eagle Lake Family Dentistry, P.a.
NPI #1528138948 in Eagle Lake, Minnesota
Provider Information
- NPI Number
- 1528138948
- Entity Type
- Organization
- Organization Name
- Eagle Lake Family Dentistry, P.a.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Nov 9, 2006
- Last Updated
- Feb 9, 2016
Practice Location
- Address
- 104 PLAINVIEW STREET
- Address 2
- BOX 97
- City
- Eagle Lake
- State
- Minnesota
- ZIP Code
- 56024
- Phone
- (507) 257-3800
Authorized Official
- Name
- DR. BRADLEY ALLAN HOLMBERG, BS, DDS
- Title
- PRESIDENT
- Phone
- (507) 257-3800
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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