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Lake Street Dental
Prosthodontist in Minneapolis, Minnesota
NPI 1184829509

Lake Street Dental is a Prosthodontist based in Minneapolis, MN and is specialized in Prosthodontics. Lake Street Dental practices in Minneapolis, MN. The NPI Number for Lake Street Dental is 1184829509 and holds a License No. D11889 (Minnesota).

The current practice location address for Lake Street Dental is 1508 E Lake St, Minneapolis, MN and can be reached out via phone at 612-724-1717.

Location: 1508 E Lake St, Minneapolis, MN, 55407-1720
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1184829509
Provider Name
Lake Street Dental
Credential
Provider Entity Type
Organization
Address
1508 E Lake St, Minneapolis, MN, 55407-1720
Phone Number
612-724-1717
Fax Number
Provider Enumeration Date
06/16/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1508 E Lake St
City
Minneapolis
State
Minnesota
Zip
55407-1720
Phone Number
612-724-1717
Fax Number
person
Provider Business Mailing Address Details
Address
1508 E Lake St
City
Minneapolis
State
Minnesota
Zip
55407-1720
Phone Number
612-724-1717
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
D12007 (Minnesota)
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.
person
Provider's Taxonomy Details 2
Type
Dental Providers
Classification
Dentist
Speciality
Periodontics
Taxonomy
1223P0300X
License No.
D11718 (Minnesota)
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
person
Provider's Taxonomy Details 3
Type
Dental Providers
Classification
Dentist
Speciality
Prosthodontics
Taxonomy
1223P0700X
License No.
D11889 (Minnesota)
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 tissues with artificial substitutes.
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