| 1st Family Dental Care | |
|
13590 Northdale Blvd Suite 300 Rogers MN 55374-2150 | |
| (763) 428-1215 | |
| (763) 428-1398 |
| Full Name | 1st Family Dental Care |
|---|---|
| Speciality | Dentist - Dental Public Health |
| Location | 13590 Northdale Blvd, Rogers, Minnesota |
| Authorized Official Name and Position | Omar Dyab (OWNER) |
| Authorized Official Contact | 7634281215 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 1st Family Dental Care 13590 Northdale Blvd Suite 300 Rogers MN 55374-2150 Ph: (763) 428-1215 | 1st Family Dental Care 13590 Northdale Blvd Suite 300 Rogers MN 55374-2150 Ph: (763) 428-1215 |
| NPI Number | 1801118039 |
|---|---|
| Provider Enumeration Date | 02/15/2010 |
| Last Update Date | 02/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801118039 | NPI | - | NPPES |
| 1235267980 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | D12346 (Minnesota) | Primary |
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