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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