Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Birch Lake Dental PA

Organization General Practice Dentistry · NPI 1083853113

Birch Lake Dental PA is a General Practice Dentistry in White Bear Lake, Minnesota. Licensed in Minnesota. Registered with an NPI since 2009.

Licensed in
MN
In the registry since
2009
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2641 White Bear Pkwy
White Bear Lake, MN 55110
Phone: (651) 429-0404
Fax: (651) 429-0472
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence D10949MN (MN)
General Practice Dentistry Taxonomy 1223G0001X · Licence 7712MN (MN)

Record details

NPI number1083853113
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Geetha Damodaran — Owner · (651) 429-0404
NPI enumeratedFebruary 12, 2009
Last updated in NPPESFebruary 12, 2009
Mailing address2641 White Bear Parkway, White Bear Lake, MN 55110

Other providers in White Bear Lake