Individual
DR. ELIAS KOUVALIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
13911 RIDGEDALE DR, SUITE 395, MINNETONKA, MN 55305-1771
(952) 545-8603
Mailing address
13911 RIDGEDALE DRIVE, SUITE 395, PARK DENTAL RIDGEPARK, MINNETONKA, MN 55305
(952) 545-8603
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11378
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
603023800
—
MN
Enumeration date
12/13/2006
Last updated
11/15/2011
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