Minnesota State Colleges and Universities

NPI #1801065958 in Brainerd, Minnesota

Provider Information

NPI Number
1801065958
Entity Type
Organization
Organization Name
Minnesota State Colleges and Universities
Subpart
Yes (part of a larger organization)
Parent Organization
MINNESOTA STATE COLLEGES AND UNIVERSITIES
Primary Specialty
Dentist - General Practice
Enumeration Date
Feb 22, 2008
Last Updated
Jul 21, 2022

Practice Location

Address
501 W COLLEGE DR
ZIP Code
56401-3904
Phone
(218) 855-8000

Authorized Official

Name
DR. LARRY LUNDBLAD
Title
PRESIDENT
Phone
(218) 855-8000

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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