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General NPI Number Information
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NPI Number | 1235042565
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Entity Type | Organization
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Legal Business Name | ADVANCED DENTAL LAB
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Dates
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Enumeration Date | 09/26/2026
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Last Update Date | 09/26/2026
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Provider Practice Location Address
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Address Line | 7362 UNIVERSITY AVE NE STE 300
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City | FRIDLEY
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State | MN
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Zip | 55432-3150
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Country | US
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Telephone | 763-571-4887
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Fax |
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Provider Business Mailing Address
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Address Line | 7362 UNIVERSITY AVE NE STE 300
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City | FRIDLEY
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State | MN
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Zip | 55432-3150
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Country | US
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Telephone | 763-571-4887
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HASS H SALTI
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Credential | CDT
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Telephone | 763-528-0775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 126900000X
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Taxonomy Name | Dental Laboratory Technician
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License Number |
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License Number State |
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