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

Lake Street Family Dental PA

Organization Dentist · NPI 1083096085

Lake Street Family Dental PA provides Dentist services in Mora, Minnesota. Licensed in Minnesota. Registered with an NPI since 2015.

Licensed in
MN
In the registry since
2015
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

119 Lake St S Ste 1
Mora, MN 55051-1576 Not confirmed with CMS for 11 years — call before visiting
Phone: (320) 679-2435
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence D13567 (MN)

Record details

NPI number1083096085
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Steven Holcombe — President · (763) 350-6234
NPI enumeratedJune 25, 2015
Last updated in NPPESJune 25, 2015
Mailing address10799 251st Ave Nw, Zimmerman, MN 55398-4558

Other providers in Mora