Glen Lake Family Dentistry P.L.L.C. in Minnetonka - General Practice
Glen Lake Family Dentistry P.L.L.C. - NPI 1740215656
Glen Lake Family Dentistry P.L.L.C. is a General Practice in Minnetonka, Minnesota. Glen Lake Family Dentistry P.L.L.C. practices all healthcare services and medical treatments related to General Practice. The NPI Number for Glen Lake Family Dentistry P.L.L.C. is 1740215656. The last update date is 2009-10-21.
Glen Lake Family Dentistry P.L.L.C.'s current location address is 5509 Eden Prairie Rd, Minnetonka, Minnesota. You can contact this provider via phone number 9529386038 and fax number 9529359175. The mailing address for Glen Lake Family Dentistry P.L.L.C. is 5509 Eden Prairie Rd, Minnetonka, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Glen Lake Family Dentistry P.L.L.C. |
|---|---|
| Address | 5509 Eden Prairie Rd, Minnetonka, Minnesota |
| Phone Number | 9529386038 |
| Fax Number | 9529359175 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DENTIST |
|---|---|
| Authorized Official Name | Olson Alan Gregory |
| Credentials | D.D.S. |
| Telephone Number | 9529386038 |
NPI Number Detail
| NPI Number | 1740215656 |
|---|---|
| Provider Enumeration Date | 2006-07-11 |
| Last Updated Date | 2009-10-21 |
Provider Mailing Address Detail
| Address | 5509 Eden Prairie Rd |
|---|---|
| City | Minnetonka |
| State | Minnesota (MN) |
| Post Code | 553455839 |
| Phone Number | 9529386038 |
| Fax Number | 9529359175 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | D11282/D1024 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 674718300 | MN | STATE MEDICAL ASSISTANCE# |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Glen Lake Family Dentistry P.L.L.C. by the Centers for Medicare & Medicaid Services?
The Glen Lake Family Dentistry P.L.L.C. has been issued the NPI (National Provider Identifier) 1740215656 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Glen Lake Family Dentistry P.L.L.C. located?
The Glen Lake Family Dentistry P.L.L.C. is located at 5509 Eden Prairie Rd, Minnetonka, MN 553455839.
What is the Glen Lake Family Dentistry P.L.L.C.'s specialty and taxonomy code?
The Glen Lake Family Dentistry P.L.L.C.'s specialty is General Practice, and the corresponding taxonomy code is 1223G0001X.
On what date did the Centers for Medicare & Medicaid Services issue the 1740215656 to Glen Lake Family Dentistry P.L.L.C.?
The Glen Lake Family Dentistry P.L.L.C. received its 1740215656 assignment from the Centers for Medicare & Medicaid Services on 2006-07-11.
As of what date was the information pertaining to Glen Lake Family Dentistry P.L.L.C., such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Glen Lake Family Dentistry P.L.L.C., including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2009-10-21.