Individual
PHONG LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9920 FOLEY BLVD NW STE 110, COON RAPIDS, MN 55433-5216
(763) 377-2110
Mailing address
9920 FOLEY BLVD NW STE 110, COON RAPIDS, MN 55433-5216
(763) 317-1166
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13699
MN
Other
Enumeration date
05/10/2016
Last updated
11/12/2025
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