Individual
SAIED MOSTAFA MOAZZAMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
515 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0357
(612) 625-2495
Mailing address
808 BERRY ST APT 124, SAINT PAUL, MN 55114-1082
(605) 691-6672
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
FL54
MN
Other
Enumeration date
05/06/2019
Last updated
05/06/2019
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