| Elk Plaza Dental | |
|
501 Main St Nw #101 Elk River MN 55330-1880 | |
| (763) 441-4200 | |
| Not Available |
| Full Name | Elk Plaza Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 501 Main St Nw, Elk River, Minnesota |
| Authorized Official Name and Position | Thomas John Hickey (OWNER) |
| Authorized Official Contact | 7634414200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elk Plaza Dental 501 Main St Nw #101 Elk River MN 55330-1880 Ph: (763) 441-4200 | Elk Plaza Dental 501 Main St Nw #101 Elk River MN 55330-1880 Ph: (763) 441-4200 |
| NPI Number | 1760592406 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760592406 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8940 (Minnesota) | Primary |
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