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General NPI Number Information
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NPI Number | 1972554145
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Entity Type | Individual
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Provider Name | INES DE LLANO D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 05/13/2006
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Last Update Date | 07/30/2010
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Provider Practice Location Address
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Address Line | 3205 W 76TH ST SUITE 1
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City | EDINA
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State | MN
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Zip | 55435-5244
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Country | US
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Telephone | 952-841-0122
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Fax | 952-896-0010
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Provider Business Mailing Address
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Address Line | 3205 W 76TH ST
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City | EDINA
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State | MN
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Zip | 55435-5244
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Country | US
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Telephone | 952-841-0122
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D11531
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License Number State | MN
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