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Individual

NISHA KAMPASI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
973 SKYLINE DR SW, ROCHESTER, MN 55902-1220
(507) 424-1040
Mailing address
4865 HERITAGE HILLS WAY, VESTAVIA, AL 35242-2258

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D14037
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
43460
ASPEN AMERICAN INSURANCE COMPANY
Enumeration date
06/08/2018
Last updated
06/08/2018
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