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Glen Lake Family Dentistry P.l.l.c.
General Practice Dentistry in Minnetonka, Minnesota
NPI 1740215656

Glen Lake Family Dentistry P.l.l.c. is a General Practice Dentistry based in Minnetonka, MN and is specialized in General Practice. Glen Lake Family Dentistry P.l.l.c. practices in Minnetonka, MN. The NPI Number for Glen Lake Family Dentistry P.l.l.c. is 1740215656 and holds a License No. D11282/D10240 (Minnesota).

The current practice location address for Glen Lake Family Dentistry P.l.l.c. is 5509 Eden Prairie Rd, Minnetonka, MN and can be reached out via phone at 952-938-6038 and via fax at 952-935-9175.

Location: 5509 Eden Prairie Rd, Minnetonka, MN, 55345-5839
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1740215656
Provider Name
Glen Lake Family Dentistry P.l.l.c.
Credential
Provider Entity Type
Organization
Address
5509 Eden Prairie Rd, Minnetonka, MN, 55345-5839
Phone Number
952-938-6038
Fax Number
952-935-9175
Provider Enumeration Date
07/11/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
674718300 01 MN STATE MEDICAL ASSISTANCE#
institution
Provider Business Practice Location Address Details
Address
5509 Eden Prairie Rd
City
Minnetonka
State
Minnesota
Zip
55345-5839
Phone Number
952-938-6038
Fax Number
952-935-9175
person
Provider Business Mailing Address Details
Address
5509 Eden Prairie Rd
City
Minnetonka
State
Minnesota
Zip
55345-5839
Phone Number
952-938-6038
Fax Number
952-935-9175
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
D11282/D10240 (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.
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