Individual
SEPI M TAGHIZADEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2534 HENNEPIN AVE, MINNEAPOLIS, MN 55405
(612) 374-4321
(612) 381-8518
Mailing address
2534 HENNEPIN AVE, MINNEAPOLIS, MN 55405
(612) 374-4321
(612) 381-8518
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10995
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11G62TA
BCBS
—
Enumeration date
11/21/2006
Last updated
07/08/2007
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