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Individual

DR. OLUWASEUN OLUMIDE FASOYIRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1290 SALEM RD SW STE 10, ROCHESTER, MN 55902-4210
(402) 617-7862
Mailing address
413 MANGROVE LN, BOSSIER CITY, LA 71111-6503
(716) 348-2654

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D14785
MN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/07/2022
Last updated
07/07/2022
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