| Round Lake Dental P.a. | |
|
13841 Round Lake Blvd Nw Andover MN 55304-3664 | |
| (763) 427-0285 | |
| (763) 576-0156 |
| Full Name | Round Lake Dental P.a. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 13841 Round Lake Blvd Nw, Andover, Minnesota |
| Authorized Official Name and Position | Thomas Richard Swenson (PRESIDENT) |
| Authorized Official Contact | 7634270285 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Round Lake Dental P.a. 13841 Round Lake Blvd Nw Andover MN 55304-3664 Ph: (763) 427-0285 | Round Lake Dental P.a. 13841 Round Lake Blvd Nw Andover MN 55304-3664 Ph: (763) 427-0285 |
| NPI Number | 1376676445 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376676445 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D10339 (Minnesota) | Primary |
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Round Lake Family Dentistry, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13841 Round Lake Blvd Nw, Andover, MN 55304 Phone: 763-427-0285 |