Taxpayer Name: Morgandia D.c./doing Business As City If Lakes Dental
NPI #1720772791 in Minneapolis, Minnesota
Provider Information
- NPI Number
- 1720772791
- Entity Type
- Organization
- Organization Name
- Taxpayer Name: Morgandia D.c./doing Business As City If Lakes Dental
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jun 5, 2023
- Last Updated
- Jun 5, 2023
Practice Location
- Address
- 5524 NICOLLET AVE.
- City
- Minneapolis
- State
- Minnesota
- ZIP Code
- 55419
- Phone
- (612) 823-1816
Authorized Official
- Name
- JAIMIE HOILAND, DDS
- Title
- DENTIST, OWNER
- Phone
- (612) 823-1816
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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