| NPI | 1811135288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAYDI ROBEIR SIDKY Owner / Dentist 952-405-8838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D12056) |
| Enumeration Date | 2009-01-23 |
| Last Update Date | 2009-01-23 |