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Organization
ABBA HEALTHCARE PLLC
Active
Organization
ABBA HEALTHCARE PLLC
Active
Other names
Cottage Grove Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EBOSETALE OKORUWA DDS (OWNER DOCTOR)
(712) 309-6588
Entity
Organization
Contact information
Practice address
6936 PINE ARBOR DR S STE 230, COTTAGE GROVE, MN 55016-4645
(651) 204-5257
Mailing address
2052 IRENE ST, ROSEVILLE, MN 55113-6613
(712) 309-6588
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/12/2024
Last updated
02/12/2024
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