Healthcare Provider Details

I. General information

NPI: 1942474457
Provider Name (Legal Business Name): TOH-ENG LIM, DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 04/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4640 SLATER RD STE 150
EAGAN MN
55122-4045
US

IV. Provider business mailing address

4640 SLATER RD STE 150
EAGAN MN
55122-4045
US

V. Phone/Fax

Practice location:
  • Phone: 651-808-5252
  • Fax: 651-808-5253
Mailing address:
  • Phone: 651-808-5252
  • Fax: 651-808-5253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JUDY K. PEDRO-LIM
Title or Position: DENTIST
Credential: DMD, MDS
Phone: 651-808-5252