Organization · NPI-2
Advanced Dental Lab
Dental Laboratory Technician · Fridley, MN
NPI number1235042565
StatusActive
Last updated in NPPESSep 26, 2026
Details
- NPI
- 1235042565
- Entity type
- Organization (NPI-2)
- Legal business name
- Advanced Dental Lab
- Organization subpart
- No
- Enumeration date
- Sep 26, 2026
- Certification date
- Sep 26, 2026
- Last updated
- Sep 26, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 126900000X | Dental Laboratory Technician | – | – | Yes |
Practice location
7362 University Ave Ne Ste 300Fridley, MN 55432-3150
Phone 763-571-4887
Mailing address
7362 University Ave Ne Ste 300Fridley, MN 55432-3150
Phone 763-571-4887
Authorized official
Hass H Salti
Owner
7635280775
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