Healthcare Provider Details

I. General information

NPI: 1154241438
Provider Name (Legal Business Name): LAURAN FRANCIS ZWACK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 WESTERN AVE STE A
FERGUS FALLS MN
56537-2403
US

IV. Provider business mailing address

944 SUNSET ST SW
HUTCHINSON MN
55350-3066
US

V. Phone/Fax

Practice location:
  • Phone: 218-998-2218
  • Fax:
Mailing address:
  • Phone: 612-723-3418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code125J00000X
TaxonomyDental Therapist
License NumberDT205
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: