Organization
DENTAL MANAGEMENT PARTNERS LLC
Active
Organization
DENTAL MANAGEMENT PARTNERS LLC
Active
Parent organization
BLAINE DENTAL LLC
Other names
Pro Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
BLAINE DENTAL LLC
Authorized official
DR. ARIF NAZIR BDS (OWNER)
(763) 231-2050
Entity
Organization
Contact information
Practice address
10210 BALTIMORE ST NE STE 100, BLAINE, MN 55449-6050
(763) 231-2050
(763) 231-2052
Mailing address
10210 BALTIMORE ST NE STE 100, BLAINE, MN 55449-6050
(763) 231-2050
Taxonomy
Speciality
Code
Description
License number
State
1223X2210X
Orofacial Pain Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
—
—
Other
Enumeration date
04/20/2022
Last updated
06/07/2022
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