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Organization
CHICAGO LAKE FAMILY DENTAL LLC
Active
Organization
CHICAGO LAKE FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI BARBARAWI DMD (GENERAL DENTIST)
(612) 823-2080
Entity
Organization
Contact information
Practice address
2900 CHICAGO AVE, MINNEAPOLIS, MN 55407-1322
(612) 823-2080
Mailing address
4893 BOATMAN LN, INVER GROVE HEIGHTS, MN 55076-1160
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/26/2017
Last updated
10/26/2017
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