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Individual

MANISHA BRAHMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2120 NICOLLET AVE, MINNEAPOLIS, MN 55404-2528
(612) 412-3641
Mailing address
2120 NICOLLET AVE, MINNEAPOLIS, MN 55404-2528
(612) 412-3641
(612) 412-3641

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D12337
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1366483802
MN
05
1558525204
MN
Enumeration date
10/10/2012
Last updated
04/09/2013
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