Individual
DR. KENTARO ISHIKAWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
190 LAKE DR E, STE 130, CHANHASSEN, MN 55317
(920) 830-4100
Mailing address
4800 EXCELSIOR BLVD APT 502, ST LOUIS PARK, MN 55416-3064
(734) 272-2714
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D13971
MN
Other
Enumeration date
10/22/2012
Last updated
05/11/2018
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