Individual
DR. RAVI N GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1405 ANNE ST NW, BEMIDJI, MN 56601-5113
(218) 444-9646
(218) 444-9252
Mailing address
1405 ANNE ST NW, BEMIDJI, MN 56601-5113
(218) 444-9646
(218) 444-9252
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
LGL5
MN
Other
Enumeration date
02/08/2011
Last updated
02/08/2011
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