Organization
AZITA LARINAJAFI, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AZITA SHEILA EBRAHIMI (OWNER DENTIST)
(651) 738-2125
Entity
Organization
Contact information
Practice address
1740 WEIR DRIVE, WOODBURY, MN 55125
(651) 738-2125
(651) 738-5902
Mailing address
1740 WEIR DRIVE, WOODBURY, MN 55125
(651) 738-2125
(651) 738-5902
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10875
MN
Other
Enumeration date
11/27/2006
Last updated
08/22/2020
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