Organization
MOUNDS VIEW FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SABRY M SHARARA DDS (OWNER/PRESIDENT)
(347) 481-6796
Entity
Organization
Contact information
Practice address
5366 EDGEWOOD DR., MOUNDS VIEW, MN 55112
(347) 481-6796
Mailing address
2458 COUNTY ROAD I, APT. 201, MOUNDSVIEW, MN 55112-6235
(347) 481-6796
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
Other
Enumeration date
08/24/2009
Last updated
08/24/2009
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