Eagle Lake Family Dentistry, PA

NPI #1689952038 in Saint James, Minnesota

Provider Information

NPI Number: 1689952038
Entity Type: Organization
Organization Name: Eagle Lake Family Dentistry, PA
Subpart: Yes (part of a larger organization)
Parent Organization: EAGLE LAKE FAMILY DENTISTRY, PA
Primary Specialty: Dentist
Enumeration Date: Aug 2, 2011
Last Updated: Aug 2, 2011

Practice Location

Address: 504 2ND AVE S
City: Saint James
State: Minnesota
ZIP Code: 56081-1737
Phone: (507) 375-4611

Authorized Official

Name: DR. SEAN PATRICK VOSTAD, DDS
Title: DENTIST
Phone: (507) 257-3800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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