Individual
BARBARA BOTOROUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
515 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0357
(612) 625-5166
Mailing address
515 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0357
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
R720
MN
Other
Enumeration date
07/09/2018
Last updated
07/09/2018
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