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

Mahtomedi Dental PC

Organization Dentist · NPI 1275969263

Mahtomedi Dental PC is a Dentist in Lake Elmo, Minnesota. Licensed in Minnesota. Registered with an NPI since 2013.

Licensed in
MN
In the registry since
2013
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

12425 55th St N
Lake Elmo, MN 55042-7403
Phone: (651) 430-1020
Fax: (651) 439-2201
Show map & directions

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

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 11396 (MN)

Record details

NPI number1275969263
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Laurie Stodola — Owner/Dentist · (651) 430-1020
Other names Grace Dental
NPI enumeratedSeptember 23, 2013
Last updated in NPPESSeptember 23, 2013
Mailing address12425 55th St N, Lake Elmo, MN 55042-7403

Other providers in Lake Elmo