| Al Shifa Dentistry Pa | |
|
12936 63rd Ave N Maple Grove MN 55369-6001 | |
| (763) 559-3400 | |
| (763) 559-3900 |
| Full Name | Al Shifa Dentistry Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 12936 63rd Ave N, Maple Grove, Minnesota |
| Authorized Official Name and Position | Nasir Latif (PRESIDENT) |
| Authorized Official Contact | 6124811976 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Al Shifa Dentistry Pa 12936 63rd Ave N Maple Grove MN 55369-6001 Ph: (763) 559-3400 | Al Shifa Dentistry Pa 12936 63rd Ave N Maple Grove MN 55369-6001 Ph: (763) 559-3400 |
| NPI Number | 1760703151 |
|---|---|
| Provider Enumeration Date | 06/19/2010 |
| Last Update Date | 06/19/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760703151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D12215 (Minnesota) | Primary |
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