| NPI | 1528133782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMED HUSSAIN Medical Director 763-323-6564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN D12190) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 42661) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2025-09-11 |