Individual
DR. BRYAN JEFFREY OPHAUG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7123 BASS LAKE RD, NEW HOPE, MN 55428-3822
(763) 533-5359
(763) 533-0010
Mailing address
5033 XERXES AVE S, MINNEAPOLIS, MN 55410-2227
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11890
MN
Other
Enumeration date
02/08/2007
Last updated
07/08/2007
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