| NPI | 1194363275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEEPAK KADEMANI Owner 612-568-0570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2019-12-19 |