Organization
MINNESOTA MAXILLOFACIAL AND ORAL CONSULTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ABDOLLAH RAHIMI D.D.S. (OWNER)
(763) 559-7688
Entity
Organization
Contact information
Practice address
15600 36TH AVE N STE 100, PLYMOUTH, MN 55446-3369
(763) 559-7688
(763) 559-2237
Mailing address
15600 36TH AVE N STE 100, PLYMOUTH, MN 55446-3369
(763) 559-7688
(763) 559-2237
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D10465
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52D13MI
BLUE CROSS/BLUE SHIELD
MN
Enumeration date
11/01/2006
Last updated
08/22/2020
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