Elk Plaza Dental

NPI #1760592406 in Elk River, Minnesota

Provider Information

NPI Number: 1760592406
Entity Type: Organization
Organization Name: Elk Plaza Dental
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 30, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 501 MAIN ST NW
Address 2: #101
City: Elk River
State: Minnesota
ZIP Code: 55330-1880
Phone: (763) 441-4200

Authorized Official

Name: DR. THOMAS JOHN HICKEY, D.D.S.
Title: OWNER
Phone: (763) 441-4200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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