| Organization Name: | ELAN DENTAL ARTS, P.C. |
| NPI Number: | 1407182629 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES HARPER PERRY (OWNER) |
| Mailing Address: | 16154 Main Ave Se Suite 110a Prior Lake |
| State: | MN US |
| Postal Code: | 553724800 |
| Phone Number: | 9524476290 |
| Fax Number: | 9524476292 |
| NPI Enumeration Date: | 10/22/2009 |
| NPI Last Update Date: | 10/22/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | D11026 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |