Individual
JUSTIN NWOSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7936 PORTLAND AVE S, BLOOMINGTON, MN 55420-1315
(952) 852-7776
Mailing address
2000 PIN OAK PKWY, BOWIE, MD 20721-3098
(301) 653-5145
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D15172
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/06/2024
Last updated
07/17/2024
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