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17 E 38th St Minneapolis MN 55409-1341 | |
| (612) 353-5443 | |
| (612) 353-5440 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 17 E 38th St, Minneapolis, Minnesota |
| Authorized Official Name and Position | Nesret Shu-ankh (PRACTICE MANAGER) |
| Authorized Official Contact | 6516479697 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
393 Dunlap St N Suite 650 Saint Paul MN 55104-4200 Ph: (651) 647-9697 | 17 E 38th St Minneapolis MN 55409-1341 Ph: (612) 353-5443 |
| NPI Number | 1366681082 |
|---|---|
| Provider Enumeration Date | 02/19/2009 |
| Last Update Date | 02/19/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366681082 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D8084 (Minnesota) | Primary |
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