Healthcare Provider Details

I. General information

NPI: 1811340409
Provider Name (Legal Business Name): ELIZABETH K LAABS D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2016
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2775 WINNETKA AVE N
NEW HOPE MN
55427-2830
US

IV. Provider business mailing address

5727 W 42ND ST
ST LOUIS PARK MN
55416-3101
US

V. Phone/Fax

Practice location:
  • Phone: 763-545-3010
  • Fax: 763-595-0543
Mailing address:
  • Phone: 612-275-1846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number016.0133924
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD13697
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: