| NPI | 1417034661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDOLLAH RAHIMI Owner 763-559-7688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN D10465) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |