NPI 1003035775

Northern Lakes Dental, LTD.

Organisation General Practice Dentistry Fergus Falls, MN

Practice location

Address: 1108 Western Ave, Fergus Falls, MN 56537-4808
Phone: (218) 736-4000
Fax: (218) 736-0766

Authorised official

Name: Scott Alan Wagnild
Title: President
Phone: (218) 736-4000

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 10677 (MN)

Other Dentist providers in Minnesota →

Registry record

NPI: 1003035775
Entity type: Organization
NPI issued: 24 Apr 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.