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General NPI Number Information
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NPI Number | 1952446338
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Entity Type | Organization
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Legal Business Name | LINDAHL FAMILY DENTAL PA
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1811 WEIR DR SUITE #265
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City | WOODBURY
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State | MN
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Zip | 55125-2272
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Country | US
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Telephone | 651-702-4200
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Fax | 651-702-0717
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Provider Business Mailing Address
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Address Line | 1811 WEIR DR SUITE #265
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City | WOODBURY
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State | MN
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Zip | 55125-2272
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Country | US
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Telephone | 651-702-4200
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Fax | 651-702-0717
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MICHAEL DEAN LINDAHL
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Credential | D.D.S.
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Telephone | 651-702-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 11031
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License Number State | MN
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