| NPI | 1295431138 |
|---|---|
| Doing Business As | COON RAPIDS MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | PARVATHI JITHENDRANATHAN Owner 763-290-6623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2023-02-02 |
| Last Update Date | 2023-02-02 |