NPI 1093490054

Thu Doan

Practitioner General Practice Dentistry St Louis Park, MN

Practice location

Address: 4959 Excelsior Blvd STE 200, St Louis Park, MN 55416-3003
Phone: (952) 260-5323
Mailing address: 4146 Trail Ridge Ln, Minnetonka, MN 55345-2500

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence D14932 (MN)

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Registry record

NPI: 1093490054
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Jun 2023
Record last updated: 19 Jun 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.