Lake Street Dental

LBN: Lake Street Dental
Lake Street Dental is an health care organization with primary practice located at 1508 E Lake St , Minneapolis MN 55407-1720. The organization recently has 3 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Periodontics, Dental Providers / Prosthodontics. Dental Providers / General Practice is the primary health care specialty. Lake Street Dental can be contacted via phone (612) 724-1717, or through Good, Renee Camara via phone (612) 724-1717.

Contact Information

Primary practice address
1508 E Lake St Minneapolis MN 55407-1720
Phone: (612) 724-1717
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Good, Renee Camara D.D.S., M.S.
Phone: (612) 724-1717

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D11889 Minnesota
Dental Providers / Periodontics 1223P0300X D11718 Minnesota
Dental Providers / Prosthodontics 1223P0700X D12007 Minnesota

Profile Details

NPI number 1184829509
LBN Legal business name Lake Street Dental
DBA Doing business as
Authorized official Good, Renee Camara D.D.S., M.S.
Entity Organization
Organization subpart 1 No
Enumeration date Jun 16th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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