Individual
FARIBA KIANMAJD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
709 RODEO DR STE 114, HUDSON, WI 54016-7758
(716) 386-3675
Mailing address
9000 CITY PLACE BLVD UNIT 2325, WOODBURY, MN 55125-5518
(916) 945-6144
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
600167115
WI
1223G0001X
General Practice Dentistry
D14963
MN
Other
Enumeration date
06/08/2023
Last updated
10/15/2024
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