Organization
MINT DENTAL SHAKOPEE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARWA GAMAM-FOREST DDS (DENTIST)
(952) 831-1332
Entity
Organization
Contact information
Practice address
205 LEWIS ST S STE 101, SHAKOPEE, MN 55379-2290
(952) 445-3349
Mailing address
205 LEWIS ST S STE 101, SHAKOPEE, MN 55379-2290
(952) 445-3349
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/04/2018
Last updated
10/04/2018
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