Organization
MONTICELLO DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HASSAN ISMAIL (OWNER)
(612) 361-5436
Entity
Organization
Contact information
Practice address
9281 CEDAR ST, MONTICELLO, MN 55362-4507
(612) 361-5436
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/12/2019
Last updated
03/12/2019
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