Healthcare Provider Details

I. General information

NPI: 1598059933
Provider Name (Legal Business Name): LINDSAY HEGLAND D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2011
Last Update Date: 06/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 JEWETT ST
MARSHALL MN
56258-2605
US

IV. Provider business mailing address

401 JEWETT ST
MARSHALL MN
56258-2605
US

V. Phone/Fax

Practice location:
  • Phone: 507-532-3353
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD12970
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: