Individual
DR. TARA KUKNYO ORECH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2600 39TH AVE NE STE 225, SAINT ANTHONY, MN 55421-5052
(763) 781-7475
Mailing address
1625 37TH AVE NE, COLUMBIA HEIGHTS, MN 55421-4043
(630) 945-4500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13817
MN
Other
Enumeration date
06/07/2017
Last updated
06/07/2017
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