LAKE SUPERIOR COLLEGE DENTAL CLINIC NPI 1740400985

NPI Information

LAKE SUPERIOR COLLEGE DENTAL CLINIC is a dental clinic center in Duluth, MN. LAKE SUPERIOR COLLEGE DENTAL CLINIC NPI is 1740400985. The provider is registered as an organization entity type.
The provider Other Name Is Lake Superior Dental Hygiene Lake Superior Community Dental Clinic.

The provider's business location address is:

2101 TRINITY ROAD
DULUTH, MN
ZIP 55811-349
Phone: (218) 733-5939
Fax: (218) 723-4921

The provider's authorized official is Cindy A Upton .
The authorized official title is Dental Hygiene Clinic Coordinator and has the following contact phone number (218) 733-5939.

The enumeration date for this NPI number is 4/30/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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