Individual
NICOLE NOTHONGKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4803 MILLER TRUNK HWY STE B, HERMANTOWN, MN 55811-4804
(218) 722-7770
Mailing address
1925 82ND AVE N, BROOKLYN PARK, MN 55444-1573
(763) 229-7577
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D14748
MN
Other
Enumeration date
06/07/2022
Last updated
06/07/2022
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