Organization
DJCM PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BECKY ROSE GRIMM (MANAGER)
(952) 474-6133
Entity
Organization
Contact information
Practice address
5524 NICOLLET AVE, MINNEAPOLIS, MN 55419-1930
(612) 823-1816
(612) 823-5955
Mailing address
5524 NICOLLET AVE, MINNEAPOLIS, MN 55419-1930
(612) 823-1816
(612) 823-5955
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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