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

Glen Lake Dental Associates, PA

Organization General Practice Dentistry · NPI 1003062084

Glen Lake Dental Associates, PA is a General Practice Dentistry in Minnetonka, Minnesota. Licensed in Minnesota. Registered with an NPI since 2008.

Licensed in
MN
In the registry since
2008
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

14418 Excelsior Blvd
Minnetonka, MN 55345-5820
Phone: (952) 935-5212
Fax: (952) 935-1391
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence D9306 (MN)

Record details

NPI number1003062084
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kent Cassidy — President · (952) 935-5212
NPI enumeratedAugust 11, 2008
Last updated in NPPESAugust 11, 2008
Mailing address14418 Excelsior Blvd, Minnetonka, MN 55345-5820

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