Individual
DR. CYRIL BOTOROUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
606 24TH AVE S STE 200, MINNEAPOLIS, MN 55454-1437
(612) 659-8689
(612) 659-8690
Mailing address
810 THORNTON ST SE APT 806, MINNEAPOLIS, MN 55414-3652
(612) 413-8429
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
R838
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R838
RESIDENT DENTAL LICENCE
MN
Enumeration date
07/22/2022
Last updated
07/22/2022
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