Organization
ELITE DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIMI HOANG DDS (MEMBER)
(952) 432-1716
Entity
Organization
Contact information
Practice address
7300 147TH ST W, SUITE 103, APPLE VALLEY, MN 55124-7541
(952) 432-1716
Mailing address
7300 147TH ST W, SUITE 103, APPLE VALLEY, MN 55124-7541
(952) 432-1716
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11923
MN
Other
Enumeration date
09/26/2006
Last updated
09/19/2014
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