Lakeshore Family Dentistry PA
NPI #1669585154 in White Bear Lake, Minnesota
Provider Information
- NPI Number
- 1669585154
- Entity Type
- Organization
- Organization Name
- Lakeshore Family Dentistry PA
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Aug 17, 2006
- Last Updated
- Aug 7, 2008
Practice Location
- Address
- 4706 BANNING AVE
- City
- White Bear Lake
- State
- Minnesota
- ZIP Code
- 55110
- Phone
- (651) 429-3348
Authorized Official
- Name
- MS. JONNI D DELGRECO
- Title
- OFFICE MANAGER
- Phone
- (651) 429-3348
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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