Lake Valley Dental Pllc

NPI #1720755531 in Wheaton, Minnesota

Provider Information

NPI Number
1720755531
Entity Type
Organization
Organization Name
Lake Valley Dental Pllc
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Aug 28, 2021
Last Updated
Aug 28, 2021

Practice Location

Address
1511 BROADWAY
ZIP Code
56296-1040
Phone
(320) 563-4800

Authorized Official

Name
DR. JOHNATHAN WERMERS, DMD
Title
DENTIST
Phone
(605) 770-8667

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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