GLACIER LAKE DENTAL P A NPI 1780235747

NPI Information

NPI: 1780235747
Provider Name: GLACIER LAKE DENTAL P A
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
10450 185TH ST W STE 500
LAKEVILLE, MN
ZIP 55044
Phone: (952) 435-9888
Get Directions

GLACIER LAKE DENTAL P A is a dental clinic center in Lakeville, MN. GLACIER LAKE DENTAL P A NPI is 1780235747. The provider is registered as an organization entity type.

The provider's business location address is:

10450 185TH ST W STE 500
LAKEVILLE, MN
ZIP 55044-690
Phone: (952) 435-9888
Fax: (952) 435-9820

The provider's authorized official is Tracy Lu Grasdal .
The authorized official title is President and has the following contact phone number (952) 486-2595.

The enumeration date for this NPI number is 9/21/2019 and was last updated on 9/21/2019.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »