Organization
SHIRAZ ASIF DDS,LLC
Active
Other names
Anderson Lake Dental
Organization subpart
No
Provider details
NPI number
Authorized official
SHIRAZ MOHAMMAD ASIF BDS (OWNER/DENTIST)
(952) 942-0823
Entity
Organization
Contact information
Practice address
8775 COLUMBINE RD, EDEN PRAIRIE, MN 55344-6695
(952) 942-0823
Mailing address
8775 COLUMBINE RD, EDEN PRAIRIE, MN 55344-6695
(952) 942-0823
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
D12191
MN
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/16/2009
Last updated
01/16/2009
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