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

Moore Lake Dental

Organization Dentist · NPI 1386035590

Moore Lake Dental is a Dentist in Fridley, Minnesota. Licensed in Minnesota. Registered with an NPI since 2015.

Licensed in
MN
In the registry since
2015

Practice location Address checks out

6230 Highway 65 NE Ste 105
Fridley, MN 55432-5107
Phone: (763) 571-5497
Show map & directions

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

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence D10520 (MN)

Record details

NPI number1386035590
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lisa Perez — Owner · (612) 414-2182
NPI enumeratedFebruary 10, 2015
Last updated in NPPESFebruary 10, 2015
Mailing address6230 Highway 65 Ne, Suite 105, Fridley, MN 55432-5107

Other providers in Fridley