Lake County Dental Ltd

NPI #1558361667 in Brainerd, Minnesota

Provider Information

NPI Number: 1558361667
Entity Type: Organization
Organization Name: Lake County Dental Ltd
Primary Specialty: Dentist
Enumeration Date: Jul 29, 2005
Last Updated: Aug 22, 2020

Practice Location

Address: 402 JAMES ST
City: Brainerd
State: Minnesota
ZIP Code: 56401-2965
Phone: (218) 829-4243

Authorized Official

Name: JEFFREY JOHN MATTSON, DDS
Title: OWNER
Phone: (218) 829-4243

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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