OrganizationActive
Birch Lake Dental PA
NPI 1083853113 · General Practice Dentistry · White Bear Lake, MN
Provider details
- NPI number
- 1083853113
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Geetha Damodaran, Owner(651) 429-0404
- License
- 7712MN (MN)
Specialties & taxonomies
Dental Providers
Dental Providers
Practice location
2641 White Bear Parkway
White Bear Lake, MN 55110
Phone: (651) 429-0404
Fax: (651) 429-0472
Approximate (ZIP-level) locationGet directions
Mailing address
2641 White Bear Parkway
White Bear Lake, MN 55110
Registry dates
- Enumerated
- 2009-02-12
- Last updated
- 2009-02-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.