Provider Demographics
NPI:1326304411
Name:QUALITY DENTAL CARE, LLC
Entity Type:Organization
Organization Name:QUALITY DENTAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:XIENG
Authorized Official - Middle Name:KHAN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:651-263-6673
Mailing Address - Street 1:9131 LOUISIANA AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55445-3249
Mailing Address - Country:US
Mailing Address - Phone:651-263-6673
Mailing Address - Fax:
Practice Address - Street 1:6901 78TH AVE N
Practice Address - Street 2:SUITE 105
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55445-2720
Practice Address - Country:US
Practice Address - Phone:651-263-6673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental