Birch Lake Dental
NPI #1922619162 in White Bear Lake, Minnesota
Provider Information
- NPI Number
- 1922619162
- Entity Type
- Organization
- Organization Name
- Birch Lake Dental
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Aug 12, 2020
- Last Updated
- Aug 12, 2020
Practice Location
- Address
- 4641 WHITE BEAR PKWY
- City
- White Bear Lake
- State
- Minnesota
- ZIP Code
- 55110-3300
- Phone
- (651) 429-0404
Authorized Official
- Name
- DR. GEETHA J DAMODARAN, DDS
- Title
- OWNER
- Phone
- (651) 429-0404
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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