Lake Street Dental in Minneapolis - Prosthodontics
Lake Street Dental - NPI 1184829509
Lake Street Dental is a Prosthodontics in Minneapolis, Minnesota. Lake Street Dental practices all healthcare services and medical treatments related to Prosthodontics. The NPI Number for Lake Street Dental is 1184829509. The last update date is 2020-08-22.
Lake Street Dental's current location address is 1508 E Lake St, Minneapolis, Minnesota. You can contact this provider via phone number 6127241717. The mailing address for Lake Street Dental is 1508 E Lake St, Minneapolis, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lake Street Dental |
|---|---|
| Address | 1508 E Lake St, Minneapolis, Minnesota |
| Phone Number | 6127241717 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PERIOSONTI |
|---|---|
| Authorized Official Name | Good Camara Renee |
| Credentials | D.D.S., M. |
| Telephone Number | 6127241717 |
NPI Number Detail
| NPI Number | 1184829509 |
|---|---|
| Provider Enumeration Date | 2007-06-16 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 1508 E Lake St |
|---|---|
| City | Minneapolis |
| State | Minnesota (MN) |
| Post Code | 554071720 |
| Phone Number | 6127241717 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Prosthodontics |
|---|---|
| Taxonomy | 1223P0700X |
| Licence No | D12007 |
|
Definition: That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial |
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What is the unique identifier code issued to Lake Street Dental by the Centers for Medicare & Medicaid Services?
The Lake Street Dental has been assigned the NPI (National Provider Identifier) 1184829509. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Lake Street Dental is physically located?
The Lake Street Dental is situated at the following address: 1508 E Lake St, Minneapolis, MN 554071720.
What is Lake Street Dental's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Lake Street Dental is Prosthodontics, and the corresponding taxonomy classification code for this specialized field is 1223P0700X.
When was the Lake Street Dental's 1184829509 issued?
The Lake Street Dental's 1184829509 was issued on 2007-06-16.
As of what date were the details pertaining to Lake Street Dental last refreshed?
The information related to the Lake Street Dental, including its address, specialty, and other relevant details, was last updated on 2020-08-22.
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