Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Eagle Lake Family Dentistry, PA

Organization General Practice Dentistry · NPI 1528138948

Eagle Lake Family Dentistry, PA provides General Practice Dentistry in Eagle Lake, Minnesota. Licensed in Minnesota. Registered with an NPI since 2006.

Licensed in
MN
In the registry since
2006
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

104 Plainview Street Box 97
Eagle Lake, MN 56024 Not confirmed with CMS for 10 years — call before visiting
Phone: (507) 257-3800
Fax: (507) 257-3456
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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 (MN)

Record details

NPI number1528138948
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bradley Holmberg — President · (507) 257-3800
NPI enumeratedNovember 9, 2006
Last updated in NPPESFebruary 9, 2016
Mailing address104 Plainview Street, Box 97, Eagle Lake, MN 56024

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